Healthcare Provider Details

I. General information

NPI: 1699934240
Provider Name (Legal Business Name): JODEE B MEDDY D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2008
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4744 EAST SUNRISE DRIVE
TUCSON AZ
85718
US

IV. Provider business mailing address

PO BOX 35130
TUCSON AZ
85740-5130
US

V. Phone/Fax

Practice location:
  • Phone: 520-207-0028
  • Fax:
Mailing address:
  • Phone: 520-207-0028
  • Fax: 520-207-5075

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number010724
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberOS015520
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: