Healthcare Provider Details

I. General information

NPI: 1407800980
Provider Name (Legal Business Name): JUDY MESSER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2006
Last Update Date: 04/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

475 S DOBSON RD
CHANDLER AZ
85224-5605
US

IV. Provider business mailing address

8728 E OAK ST
MESA AZ
85207-9108
US

V. Phone/Fax

Practice location:
  • Phone: 480-917-1648
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number28991
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number28991
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: