JDL-CTSPA NPI 1831353382

NPI Information

  • NPI: 1831353382
  • Provider Name: JDL-CTSPA
  • Classification: Physician Assistant - 363AS0400X
  • Specialization: Surgical
  • Entity Type: Organization
  • Address: 4521 W HOPI TRL
    LAVEEN, AZ
    ZIP 85339
  • Phone: (602) 795-3371

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NPI Details

JDL-CTSPA is a surgical physician assistant in Laveen, AZ. JDL-CTSPA NPI is 1831353382. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

4521 W HOPI TRL
LAVEEN, AZ
ZIP 85339-068
Phone: (602) 795-3371

The provider's authorized official is Jeanine Diane Lutgen .
The authorized official title is Manager and has the following contact phone number (602) 795-3371.

The enumeration date for this NPI number is 7/14/2008 and was last updated on 4/8/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363AS0400XPhysician AssistantSurgical3608ARIZONAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1Z123651OTHERARIZONAMEDICARE PTAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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