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NPI Code Detail

MEDICARE: WILLIAM JORDAN FLAKE DO

MEDICARE: WILLIAM JORDAN FLAKE DO
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
1390200000XStudent in an Organized Health Care Education/Training Program
2207Q00000XFamily Medicine PhysicianR4682AZ

General Provider Information

NPI Number : 1629860085
Entity Type Code : Individual
Provider Name (Legal Business Name) : WILLIAM JORDAN FLAKE DO
Provider Business Mailing Address
First Line : 655 N ALVERNON WAY STE 228
Second Line :
City : TUCSON
State : AZ
Zip : 85711-1853
Country : US
Telephone Number :
Fax Number : 520-694-1640
Provider Business Practice Location Address
First Line : 655 N ALVERNON WAY STE 228
Second Line :
City : TUCSON
State : AZ
Zip : 85711-1853
Country : US
Telephone Number : 520-724-7770
Fax Number : 520-694-1640
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/21/2025
Last Update Date : 07/22/2025

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Directions to “ WILLIAM JORDAN FLAKE DO” Practice Location

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