Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | 53996 | AZ |
N | 208200000X | Surgeon | 110117 | CA |
N | 208600000X | Surgeon | 110117 | CA |
N | 208200000X | Surgeon | 53996 | AZ |
N | 208600000X | Surgeon | 53996 | AZ |
NPI | 1164758264 |
---|---|
Provider Name | Dr. Jack W Harbell |
First Address | Scottsdale, AZ 85259-5452 |
Second Address | Scottsdale, AZ 85259-5452 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/10/2009 |
Last Update Date | 05/10/2020 |