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General NPI Number Information
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NPI Number | 1154543379
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Entity Type | Organization
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Legal Business Name | S. JAYACHANDRAN, M.D. P.C.
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 08/19/2008
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Provider Practice Location Address
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Address Line | 14674 W MOUNTAIN VIEW BLVD STE 210
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City | SURPRISE
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State | AZ
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Zip | 85374-2708
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Country | US
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Telephone | 623-546-1400
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Fax | 623-544-5921
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Provider Business Mailing Address
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Address Line | 4212 E MARLETTE AVE
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City | PARADISE VALLEY
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State | AZ
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Zip | 85253
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Country | US
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Telephone | 623-546-1400
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Fax | 623-544-5921
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SUNDARARAJAN NMI JAYACHANDRAN
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Credential | MD
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Telephone | 623-546-1400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 14860
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License Number State | AZ
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