Healthcare Provider Details
I. General information
NPI: 1942270947
Provider Name (Legal Business Name): JANET R REISER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 01/24/2006
Last Update Date: 12/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7331 E OSBORN DR SUITE 250
SCOTTSDALE AZ
85251-6435
US
IV. Provider business mailing address
7331 E OSBORN DR SUITE 250
SCOTTSDALE AZ
85251-6435
US
V. Phone/Fax
- Phone: 480-646-8444
- Fax: 480-646-8445
- Phone: 480-646-8444
- Fax: 480-646-8445
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RG0100X |
| Taxonomy | Gastroenterology Physician |
| License Number | 29358 |
| License Number State | AZ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: