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NPI Code Detail

MEDICARE: JEFFREY DAVID BEZARD

MEDICARE: JEFFREY DAVID BEZARD
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
1183500000XPharmacistS026477AZ

General Provider Information

NPI Number : 1831877687
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEFFREY DAVID BEZARD
Provider Business Mailing Address
First Line : 2302 N CENTRAL AVE STE 7
Second Line :
City : PHOENIX
State : AZ
Zip : 85004-1332
Country : US
Telephone Number : 602-313-2042
Fax Number : 602-313-2044
Provider Business Practice Location Address
First Line : 2302 N CENTRAL AVE STE 7
Second Line :
City : PHOENIX
State : AZ
Zip : 85004-1332
Country : US
Telephone Number : 602-313-2042
Fax Number : 602-313-2044
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/10/2023
Last Update Date : 07/10/2023

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Directions to “ JEFFREY DAVID BEZARD ” Practice Location

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