Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PE0004X | Emergency Medical Services | LT0063 | AZ |
NPI | 1164461729 |
---|---|
Provider Name | John P Deuel |
First Address | Phoenix, AZ 85027-4171 |
Second Address | Anthem, AZ 85086-7001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2006 |
Last Update Date | 24/09/2013 |