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General NPI Number Information
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NPI Number | 1164698783
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Entity Type | Organization
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Legal Business Name | ACADEMIC UROLOGY AND UROGYNECOLOGY OF ARIZONA PC
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Dates
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Enumeration Date | 05/03/2008
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Last Update Date | 02/19/2016
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Provider Practice Location Address
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Address Line | 14044 W CAMELBACK RD SUITE 118 AND 216
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City | LITCHFIELD PARK
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State | AZ
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Zip | 85340-9428
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Country | US
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Telephone | 623-547-2600
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Fax | 623-547-1899
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Provider Business Mailing Address
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Address Line | 14044 W CAMELBACK RD SUITE 118
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City | LITCHFIELD PARK
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State | AZ
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Zip | 85340-9428
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Country | US
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Telephone | 623-547-2600
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JEFFREY ALAN STERN
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Credential | M.D.
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Telephone | 623-547-2600
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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 | 33193
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License Number State | AZ
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