Healthcare Provider Details

I. General information

NPI: 1821402793
Provider Name (Legal Business Name): JOSHUA MAKHOUL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2014
Last Update Date: 03/18/2026
Certification Date: 03/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10214 N TATUM BLVD STE A600
PHOENIX AZ
85028-4247
US

IV. Provider business mailing address

PO BOX 33269
PHOENIX AZ
85067-3269
US

V. Phone/Fax

Practice location:
  • Phone: 602-406-1530
  • Fax:
Mailing address:
  • Phone: 602-406-4786
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number62535
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: