Healthcare Provider Details
I. General information
NPI: 1942249495
Provider Name (Legal Business Name): ROXANNE M. HECHT MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/06/2006
Last Update Date: 07/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2525 E ROOSEVELT ST
PHOENIX AZ
85008-4948
US
IV. Provider business mailing address
2929 E THOMAS RD
PHOENIX AZ
85016-8034
US
V. Phone/Fax
- Phone: 602-344-5343
- Fax: 602-344-5859
- Phone: 602-470-5000
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2080P0206X |
| Taxonomy | Pediatric Gastroenterology Physician |
| License Number | 11952 |
| License Number State | AZ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: