Organization
J. ROBERT WEST, M.D., INC
Active
Other names
West Dermatology of Arizona
Organization subpart
No
Provider details
NPI number
Authorized official
LUCIUS BLANCHARD M.D. (OWNER/PHYSICIAN)
(702) 360-2100
Entity
Organization
Contact information
Practice address
1729 N TREKELL RD STE 124, CASA GRANDE, AZ 85122-2215
(520) 421-7100
(520) 421-1300
Mailing address
12700 PARK CENTRAL DR STE 1210, DALLAS, TX 75251-1522
(702) 360-2763
(949) 783-2880
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
40312
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DP3049
RAILROAD MEDICARE 08/01/09
AZ
Enumeration date
08/17/2009
Last updated
03/26/2024
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