Healthcare Provider Details

I. General information

NPI: 1689654261
Provider Name (Legal Business Name): JEF LEBER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/19/2006
Last Update Date: 02/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16635 N 43RD AVE
PHOENIX AZ
85053-2707
US

IV. Provider business mailing address

25500 N NORTERRA DR
PHOENIX AZ
85085-8200
US

V. Phone/Fax

Practice location:
  • Phone: 602-843-7900
  • Fax:
Mailing address:
  • Phone: 623-277-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number22445
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: