Individual
JYOTHI PUNNAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
483 W SEED FARM RD, SACATON, AZ 85147-5000
(602) 528-1200
(602) 528-1255
Mailing address
PO BOX 115, SACATON, AZ 85147-0002
(520) 796-2600
(602) 528-1296
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
40129
AZ
208M00000X
Hospitalist Physician
40129
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
371082
—
AZ
Enumeration date
05/23/2007
Last updated
02/12/2024
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