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General NPI Number Information
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NPI Number | 1730079716
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Entity Type | Organization
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Legal Business Name | JBM SURGICAL PLLC
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Dates
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Enumeration Date | 07/09/2025
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Last Update Date | 07/17/2025
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Provider Practice Location Address
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Address Line | 1155 N REAY LN
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City | THATCHER
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State | AZ
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Zip | 85552-4301
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Country | US
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Telephone | 928-792-7647
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Fax |
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Provider Business Mailing Address
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Address Line | 1155 N REAY LN
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City | THATCHER
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State | AZ
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Zip | 85552-4301
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Country | US
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Telephone | 928-792-7647
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Fax |
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | JORDEN MARBLE
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Credential | MD
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Telephone | 928-792-7647
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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