Healthcare Provider Details

I. General information

NPI: 1427023456
Provider Name (Legal Business Name): JAMES JOHN BOUZOUKIS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/22/2006
Last Update Date: 11/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9155 E BELL RD
SCOTTSDALE AZ
85260
US

IV. Provider business mailing address

9155 E BELL RD
SCOTTSDALE AZ
85260
US

V. Phone/Fax

Practice location:
  • Phone: 480-889-8877
  • Fax: 480-889-8878
Mailing address:
  • Phone: 480-889-8877
  • Fax: 480-889-8878

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YX0905X
TaxonomyOtolaryngology/Facial Plastic Surgery Physician
License Number30243
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: