Bangert, Jerry Lee
Bangert, Jerry Lee is an sole proprietor health care provider with primary practice located at 7356 North La Cholla Blvd. , Tucson AZ 85741. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Dermatology, Allopathic & Osteopathic Physicians / Dermatopathology. Allopathic & Osteopathic Physicians / Dermatology is his primary health care specialty. Bangert, Jerry Lee can be contacted via phone (520) 575-1007.Contact Information
Primary practice address
7356 North La Cholla Blvd.
Tucson AZ 85741
Phone: (520) 575-1007
Fax: (214) 596-7422
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | 11270 | Arizona |
| Allopathic & Osteopathic Physicians / Dermatopathology | 207ND0900X | 11270 | Arizona |
Profile Details
| NPI number | 1578529855 |
|---|---|
| LBN Legal business name | Bangert, Jerry Lee |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 25th, 2006 |
| Last updated | Nov 25th, 2013 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1578529855 | NPPES |
| Arizona | MEDICAID | 263062 |
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