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Individual

DR. JULIENE CLARE GENTRY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
2000 W BETHANY HOME RD, PHOENIX, AZ 85015-2443
(602) 246-5665
(602) 246-5376
Mailing address
9664 E IDAHO AVE, MESA, AZ 85209-7061
(480) 986-0272

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A052000
CA
208000000X
Pediatrics Physician
A052000
CA
208M00000X
Hospitalist Physician
3203-320
WI
208M00000X
Hospitalist Physician
Primary
329863
NY
208M00000X
Hospitalist Physician
36226
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1144205329
BCBS OF ARIZONA
AZ
05
164441
AZ
Enumeration date
12/12/2005
Last updated
01/14/2025
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