Healthcare Provider Details

I. General information

NPI: 1932146073
Provider Name (Legal Business Name): JOHN ARTHUR LIEBERT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/31/2006
Last Update Date: 03/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8700 E PINNACLE PEAK RD SUITE 103
SCOTTSDALE AZ
85255-3540
US

IV. Provider business mailing address

8700 E PINNACLE PEAK RD SUITE 103
SCOTTSDALE AZ
85255-3540
US

V. Phone/Fax

Practice location:
  • Phone: 602-349-0025
  • Fax: 480-502-9465
Mailing address:
  • Phone: 602-349-0025
  • Fax: 480-502-9465

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number24378
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: