MEDICARE: DR. JOEL VICTOR BRILL MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RG0100X	Gastroenterology Physician	25553	AZ

General Provider Information

NPI Number	:	1417952789
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOEL VICTOR BRILL MD

Provider Business Mailing Address
First Line	:	3639 E DENTON LN
Second Line	:
City	:	PARADISE VALLEY
State	:	AZ
Zip	:	85253-7508
Country	:	US
Telephone Number	:	602-418-8744
Fax Number	:	480-452-0424

Provider Business Practice Location Address
First Line	:	3639 E DENTON LN
Second Line	:
City	:	PARADISE VALLEY
State	:	AZ
Zip	:	85253-7508
Country	:	US
Telephone Number	:	602-418-8744
Fax Number	:	480-452-0424

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/14/2005
Last Update Date	:	12/05/2012

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