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NPI Code Detail

MEDICARE: JOCELYN VERDUGO DO

MEDICARE: JOCELYN VERDUGO DO
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
1207Q00000XFamily Medicine Physician007304AZ

General Provider Information

NPI Number : 1861804270
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOCELYN VERDUGO DO
Provider Business Mailing Address
First Line : 3003 N CENTRAL AVE STE 400
Second Line :
City : PHOENIX
State : AZ
Zip : 85012-2929
Country : US
Telephone Number : 602-685-6000
Fax Number : 602-302-7925
Provider Business Practice Location Address
First Line : 6151-6153 W OLIVE AVE
Second Line :
City : GLENDALE
State : AZ
Zip : 85302-4598
Country : US
Telephone Number : 602-685-6000
Fax Number : 602-389-3599
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/20/2014
Last Update Date : 07/25/2022

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