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General NPI Number Information
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NPI Number | 1760804991
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Entity Type | Individual
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Provider Name | DR. MIKKEL JARMAN
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Gender | Male
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Dates
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Enumeration Date | 01/07/2014
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Last Update Date | 08/10/2020
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Provider Practice Location Address
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Address Line | 633 E RAY RD STE 128
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City | GILBERT
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State | AZ
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Zip | 85296-4200
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Country | US
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Telephone | 480-497-3946
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Fax | 480-497-3947
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Provider Business Mailing Address
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Address Line | 633 E RAY RD STE 128
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City | GILBERT
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State | AZ
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Zip | 85296-4200
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Country | US
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Telephone | 480-497-3946
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Fax | 480-497-3947
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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 | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 0776
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License Number State | AZ
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