Organization
JAVELINA PEDIATRICS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PHILIP S TRAQUAIR MD (PRESIDENT)
(520) 531-0060
Entity
Organization
Contact information
Practice address
1521 E TANGERINE RD, SUITE 205, ORO VALLEY, AZ 85755-6225
(520) 531-0060
(520) 225-0156
Mailing address
1521 E TANGERINE RD, SUITE 205, ORO VALLEY, AZ 85755-6225
(520) 531-0060
(520) 225-0156
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
33911
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
945925
—
AZ
Enumeration date
07/07/2006
Last updated
01/21/2009
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