Organization
JEAN LETARTE MD PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEAN LETARTE MD (OWNER)
(520) 340-4283
Entity
Organization
Contact information
Practice address
1515 E FLORENCE BLVD STE 102, CASA GRANDE, AZ 85122-5334
(520) 340-4283
Mailing address
1515 E FLORENCE BLVD STE 102, CASA GRANDE, AZ 85122-5334
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
19277
ARIZONA MEDICAL LICENSE
AZ
Enumeration date
10/01/2018
Last updated
10/01/2018
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