Healthcare Provider Details

I. General information

NPI: 1568444875
Provider Name (Legal Business Name): JOSE FRANCISCO CARRAZCO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: JOSE FRANCISCO CARRASCO M.D.

II. Dates (important events)

Enumeration Date: 11/14/2005
Last Update Date: 11/17/2024
Certification Date: 11/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2033 E WARNER RD STE 109
TEMPE AZ
85284
US

IV. Provider business mailing address

2033 E WARNER RD STE 109
TEMPE AZ
85284-3417
US

V. Phone/Fax

Practice location:
  • Phone: 480-820-5525
  • Fax: 480-831-6755
Mailing address:
  • Phone: 480-820-5525
  • Fax: 480-831-6755

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number24255
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number24255
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: