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General NPI Number Information
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NPI Number | 1033419429
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Entity Type | Individual
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Provider Name | DR. ROEL CONRAD JAMIS
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Gender | Male
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Dates
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Enumeration Date | 11/01/2010
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Last Update Date | 01/26/2023
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Provider Practice Location Address
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Address Line | 17674 N LITCHFIELD RD
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City | SURPRISE
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State | AZ
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Zip | 85374-2478
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Country | US
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Telephone | 623-281-3001
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Fax | 623-281-3003
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Provider Business Mailing Address
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Address Line | 102 WOODMONT BLVD STE 600
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City | NASHVILLE
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State | TN
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Zip | 37205-5250
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Country | US
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Telephone | 615-314-5257
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 036133872
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 58522
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License Number State | AZ
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