Jerry Lee Bangert
Dermatologist Dermatopathologist
7356 North La Cholla Blvd.
Tucson
, Arizona 85741
Jerry Lee Bangert
Dermatologist Dermatopathologist
7356 North La Cholla Blvd.
Tucson
, Arizona 85741
(972) 331-3148
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About
Features
Specialties
- Dermatologist
- Dermatopathologist
Languages spoken
- English
Location
First Address
- Jerry Lee Bangert
- Po Box 844777
- Dallas, TX
- Zip : 75284-4777
- Fax : (972) 331-3148
- Phone : (888) 344-1160
Second Address
- Jerry Lee Bangert
- 7356 North La Cholla Blvd.
- Tucson, AZ
- Zip : 85741
- Fax : (214) 596-7422
- Phone : (520) 575-1007
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207N00000X | Dermatologist | 11270 | AZ |
| N | 207ND0900X | Dermatopathologist | 11270 | AZ |
National Provider Identifier
| NPI | 1578529855 |
|---|---|
| Provider Name | Jerry Lee Bangert |
| First Address | Dallas, TX 75284-4777 |
| Second Address | Tucson, AZ 85741 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 25/04/2006 |
| Last Update Date | 25/11/2013 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 263062 | (05) | AZ |
| D36521 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.