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General NPI Number Information
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NPI Number | 1477013274
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Entity Type | Individual
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Provider Name | JESSICA MARIE SILVA DO
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Gender | Female
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Dates
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Enumeration Date | 03/20/2019
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Last Update Date | 08/15/2023
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Provider Practice Location Address
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Address Line | 3311 N 44TH ST
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City | PHOENIX
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State | AZ
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Zip | 85018-6461
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Country | US
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Telephone | 480-882-7360
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Fax |
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Provider Business Mailing Address
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Address Line | 2014 N 51ST WAY
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City | PHOENIX
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State | AZ
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Zip | 85008-4254
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Country | US
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Telephone | 702-622-5449
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 008796
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License Number State | AZ
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