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General NPI Number Information
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NPI Number | 1710954664
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Entity Type | Individual
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Provider Name | JAMES L EVERETT M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/28/2006
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Last Update Date | 10/11/2011
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Provider Practice Location Address
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Address Line | 1625 E NORTHERN AVE SUITE 103
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City | PHOENIX
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State | AZ
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Zip | 85020-3960
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Country | US
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Telephone | 602-957-4841
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Fax |
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Provider Business Mailing Address
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Address Line | 5325 E LARKSPUR DR
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City | SCOTTSDALE
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State | AZ
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Zip | 85254-4227
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Country | US
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Telephone | 602-957-4841
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 15950
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License Number State | AZ
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