Corey L Detlefs Md

LBN: Corey L Detlefs Md
Corey L Detlefs Md is an health care organization with primary practice located at 2320 N 3Rd St , Phoenix AZ 85004-1303. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as the primary health care specialty. Corey L Detlefs Md can be contacted via phone (602) 340-0201, or through Detlefs, Corey L via phone (602) 340-0201.

Contact Information

Primary practice address
2320 N 3Rd St Phoenix AZ 85004-1303
Phone: (602) 340-0201
Fax: (602) 441-5115
Website:
Map and Directions
Authorized official contact:
Name: Detlefs, Corey L Doctor of Medicine (MD)
Phone: (602) 340-0201

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 19043 Arizona

Profile Details

NPI number 1396822482
LBN Legal business name Corey L Detlefs Md
DBA Doing business as
Authorized official Detlefs, Corey L Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Nov 1st, 2006
Last updated Dec 6th, 2007 - about 18 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1396822482 NPPES
Arizona MEDICAID 140179

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