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General NPI Number Information
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NPI Number | 1902022080
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Entity Type | Organization
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Legal Business Name | JUSTICE TRAN MD PC
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Dates
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Enumeration Date | 04/17/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1498 S 20TH AVE
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City | SAFFORD
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State | AZ
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Zip | 85546-4052
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Country | US
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Telephone | 928-348-8208
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Fax | 928-348-8209
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Provider Business Mailing Address
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Address Line | 1498 S 20TH AVE
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City | SAFFORD
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State | AZ
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Zip | 85546-4052
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Country | US
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Telephone | 928-348-8208
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Fax | 928-348-8209
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JUSTICE D TRAN
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Credential | MD
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Telephone | 928-348-8208
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VX0000X
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Taxonomy Name | Obstetrics Physician
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License Number | 33525
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License Number State | AZ
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