Individual
RANDY JAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
4550 E BELL RD STE 170, PHOENIX, AZ 85032-9385
(480) 443-8400
(480) 443-8697
Mailing address
4550 E. BELL ROAD, SUITE 170, PHOENEX, AZ 85032
(480) 443-8400
(480) 443-8697
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1349
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1349
STATE MEDICAL LICENSE - PA
AZ
Enumeration date
11/15/2006
Last updated
03/07/2023
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