Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | 29646 | AZ |
NPI | 1003896713 |
---|---|
Provider Name | Jeffrey Parker Morray |
First Address | Phoenix, AZ 85012-2738 |
Second Address | Phoenix, AZ 85012-2738 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/01/2006 |
Last Update Date | 20/11/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
622903 | (05) | AZ |
A14751 | (02) |