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General NPI Number Information
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NPI Number | 1902232408
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Entity Type | Organization
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Legal Business Name | JOHN A LIEBERT, MD PC
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Dates
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Enumeration Date | 09/17/2013
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Last Update Date | 09/17/2013
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Provider Practice Location Address
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Address Line | 5450 E HIGH ST SUITE 300
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City | PHOENIX
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State | AZ
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Zip | 85054-5458
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Country | US
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Telephone | 602-349-0025
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Fax | 480-502-9465
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Provider Business Mailing Address
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Address Line | 5450 E HIGH ST SUITE 300
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City | PHOENIX
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State | AZ
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Zip | 85054-5458
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Country | US
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Telephone | 602-349-0025
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Fax | 480-502-9465
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOHN ARTHUR LIEBERT
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Credential | MD
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Telephone | 602-349-0025
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 24378
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License Number State | AZ
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