Individual
JENNIFER DUMBOLTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
122 E MAIN ST, PAYSON, AZ 85541-5574
(928) 474-2888
(928) 474-2992
Mailing address
122 E MAIN ST, PAYSON, AZ 85541-5574
(928) 474-2888
(928) 474-2992
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
005119
AZ
207Q00000X
Family Medicine Physician
R-7684
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0476960
—
IA
05
—
386378
—
AZ
Enumeration date
01/05/2007
Last updated
12/30/2008
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