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NPI Code Detail

MEDICARE: JAMIE L LANDAU AU.D.

MEDICARE: JAMIE L LANDAU AU.D.
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
1231H00000XAudiologistAU2259CA
2231H00000XAudiologistDA6702AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1AU2259OTHERCASTATE LICENSE

General Provider Information

NPI Number : 1679799092
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMIE L LANDAU AU.D.
Provider Business Mailing Address
First Line : PO BOX 43160
Second Line :
City : TUCSON
State : AZ
Zip : 85733-3160
Country : US
Telephone Number : 520-775-3333
Fax Number : 520-775-3334
Provider Business Practice Location Address
First Line : 6340 N CAMPBELL AVE STE 256
Second Line :
City : TUCSON
State : AZ
Zip : 85718-3186
Country : US
Telephone Number : 520-775-3333
Fax Number : 520-775-3334
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/17/2007
Last Update Date : 08/16/2021

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