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NPI Code Detail

MEDICARE: JENNIFER CHRISTY D.O.

MEDICARE: JENNIFER CHRISTY D.O.
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
1208000000XPediatrics Physician7727AK
2208000000XPediatrics Physician008030AZ

General Provider Information

NPI Number : 1811125545
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER CHRISTY D.O.
Provider Business Mailing Address
First Line : 3200 E CAMELBACK RD STE 250
Second Line :
City : PHOENIX
State : AZ
Zip : 85018-2327
Country : US
Telephone Number : 602-933-1813
Fax Number :
Provider Business Practice Location Address
First Line : 800 COVE PKWY
Second Line :
City : COTTONWOOD
State : AZ
Zip : 86326-4644
Country : US
Telephone Number : 928-649-3003
Fax Number : 928-649-3030
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/01/2009
Last Update Date : 07/23/2019

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