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NPI Code Detail

MEDICARE: JEAN M. AMON M.D.

MEDICARE: JEAN M. AMON M.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
1208000000XPediatrics Physician33054AZ

General Provider Information

NPI Number : 1689658163
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEAN M. AMON M.D.
Provider Business Mailing Address
First Line : 2400 S AVENUE A
Second Line :
City : YUMA
State : AZ
Zip : 85364-7127
Country : US
Telephone Number : 928-344-2000
Fax Number : 928-722-6113
Provider Business Practice Location Address
First Line : 2400 S AVENUE A
Second Line :
City : YUMA
State : AZ
Zip : 85364-7170
Country : US
Telephone Number : 928-336-3213
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/30/2005
Last Update Date : 11/08/2024

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