Healthcare Provider Details

I. General information

NPI: 1194806646
Provider Name (Legal Business Name): JAMES J WITMAN NMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/18/2006
Last Update Date: 03/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8131 E INDIAN BEND RD
SCOTTSDALE AZ
85250-4822
US

IV. Provider business mailing address

840 E MARCO POLO RD
PHOENIX AZ
85024-1136
US

V. Phone/Fax

Practice location:
  • Phone: 480-883-7240
  • Fax: 480-883-7241
Mailing address:
  • Phone: 480-251-6866
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number01655
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: