Healthcare Provider Details

I. General information

NPI: 1104104488
Provider Name (Legal Business Name): JARVIS TZENG, DO, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2011
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 10 N TATUM BLVD 102-132
PHOENIX AZ
85028
US

IV. Provider business mailing address

428 CHILDERS ST STE 23343
PENSACOLA FL
32534-9630
US

V. Phone/Fax

Practice location:
  • Phone: 480-389-6863
  • Fax: 888-819-9648
Mailing address:
  • Phone: 480-389-6863
  • Fax: 888-819-9648

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: JARVIS ARTHUR TZENG
Title or Position: PRESIDENT
Credential: DO
Phone: 480-389-6863