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NPI Code Detail

MEDICARE: DR. JAMES GORDON LEIFERMAN MD

MEDICARE: DR. JAMES GORDON LEIFERMAN MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics Physician20527AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
14643028OTHERAETNA
2AZ02350870OTHERBC/BS
3121351OTHERHEALTH NET

General Provider Information

NPI Number : 1255339859
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JAMES GORDON LEIFERMAN MD
Provider Business Mailing Address
First Line : 2400 S AVENUE A
Second Line :
City : YUMA
State : AZ
Zip : 85364-7170
Country : US
Telephone Number : 928-344-2000
Fax Number :
Provider Business Practice Location Address
First Line : 2400 S AVENUE A
Second Line : PROFESSIONAL SERVICES GROUP
City : YUMA
State : AZ
Zip : 85364-7127
Country : US
Telephone Number : 928-336-3035
Fax Number : 928-336-7776
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/08/2005
Last Update Date : 01/02/2025

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