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NPI Code Detail

MEDICARE: DR. GERALD JOHN NEUFANG III D.C.

MEDICARE:  DR. GERALD JOHN NEUFANG III D.C.
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
1111N00000XChiropractor8790AZ

General Provider Information

NPI Number : 1679031942
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GERALD JOHN NEUFANG III D.C.
Provider Business Mailing Address
First Line : 11011 S 48TH ST STE 108
Second Line :
City : PHOENIX
State : AZ
Zip : 85044-1787
Country : US
Telephone Number : 480-893-2412
Fax Number : 480-893-2412
Provider Business Practice Location Address
First Line : 11011 S 48TH ST STE 108
Second Line :
City : PHOENIX
State : AZ
Zip : 85044-1787
Country : US
Telephone Number : 480-893-2412
Fax Number : 480-893-2412
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/06/2019
Last Update Date : 03/06/2019

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Directions to “ DR. GERALD JOHN NEUFANG III D.C.” Practice Location

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