Healthcare Provider Details

I. General information

NPI: 1528065422
Provider Name (Legal Business Name): JAMES JOSEPH DEARING D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2005
Last Update Date: 09/24/2013
Certification Date:
Deactivation Date: 03/21/2006
Reactivation Date: 04/06/2006

III. Provider practice location address

19841 N. 27TH AVENUE SUITE 101
PHOENIX AZ
85027-4002
US

IV. Provider business mailing address

2500 W UTOPIA RD STE. 100
PHOENIX AZ
85027-4171
US

V. Phone/Fax

Practice location:
  • Phone: 602-942-8512
  • Fax: 602-942-1075
Mailing address:
  • Phone: 602-214-6148
  • Fax: 602-214-6149

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2115
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: