Individual
DR. JASON SCOTT COUCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2510 W DUNLAP AVE STE 290, SUITE # 290, PHOENIX, AZ 85021-2759
(602) 789-0344
Mailing address
3829 E DEWBERRY AVE, MESA, AZ 85206-1826
(480) 381-3103
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
006693
AZ
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
006693
AZ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/01/2011
Last updated
07/30/2017
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