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General NPI Number Information
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NPI Number | 1871541599
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Entity Type | Organization
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Legal Business Name | JEFFREY A VAN LIER RIBBINK M.D. P.C.
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Dates
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Enumeration Date | 05/05/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 10290 N 92ND ST SUITE 305
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City | SCOTTSDALE
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State | AZ
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Zip | 85258-4522
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Country | US
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Telephone | 480-941-0866
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Fax | 602-952-1211
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Provider Business Mailing Address
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Address Line | 5235 E PALO VERDE PL
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City | PARADISE VALLEY
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State | AZ
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Zip | 85253-3344
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Country | US
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Telephone | 602-952-2059
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Fax | 602-952-1211
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JEFFREY ANTHONY VAN LIER RIBBINK
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Credential | M.D.
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Telephone | 480-941-0866
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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 | 18860
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License Number State | AZ
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