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NPI Code Detail

MEDICARE: JACK E TOBEY CRNA MS

MEDICARE:   JACK E TOBEY  CRNA MS
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
1367500000XCertified Registered Nurse AnesthetistRN067637AZ

General Provider Information

NPI Number : 1417940370
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACK E TOBEY CRNA MS
Provider Business Mailing Address
First Line : 8144 E CACTUS RD STE 800
Second Line :
City : SCOTTSDALE
State : AZ
Zip : 85260-5266
Country : US
Telephone Number : 602-463-7314
Fax Number :
Provider Business Practice Location Address
First Line : 14502 W MEEKER BLVD
Second Line :
City : SUN CITY WEST
State : AZ
Zip : 85375-5282
Country : US
Telephone Number : 623-524-4000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/25/2005
Last Update Date : 10/19/2012

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