Healthcare Provider Details

I. General information

NPI: 1770529240
Provider Name (Legal Business Name): WES JON ARLEIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2006
Last Update Date: 08/23/2021
Certification Date: 08/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 E MCDOWELL RD STE 103
PHOENIX AZ
85006-2607
US

IV. Provider business mailing address

3810 NORTHDALE BLVD STE 150
TAMPA FL
33624-1871
US

V. Phone/Fax

Practice location:
  • Phone: 800-991-6117
  • Fax:
Mailing address:
  • Phone: 813-961-1331
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License NumberM-12006
License Number StateID
# 2
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number31856
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: