Individual
DR. EUGENE JOHN SIDOTI JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2601 E ROOSEVELT ST, PHOENIX, AZ 85008-4973
(602) 344-5011
(602) 344-5596
Mailing address
2929 E THOMAS RD, PHOENIX, AZ 85016-8034
(602) 470-5000
(602) 470-5064
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
175407
NY
208200000X
Plastic Surgery Physician
175407
NY
208200000X
Plastic Surgery Physician
59440
AZ
2082S0099X
Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician
175407
NY
2082S0099X
Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician
59440
AZ
2082S0105X
Surgery of the Hand (Plastic Surgery) Physician
175407
NY
2082S0105X
Surgery of the Hand (Plastic Surgery) Physician
59440
AZ
2086S0122X
Plastic and Reconstructive Surgery Physician
175407
NY
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
59440
AZ
Other
Enumeration date
08/10/2006
Last updated
11/07/2019
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