Organization
JEFFREY S. IZENBERG, DO, LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY IZENBERG DO (PHYSICIAN)
(928) 532-8386
Entity
Organization
Contact information
Practice address
5171 CUB LAKE RD STE B210, SHOW LOW, AZ 85901-7866
(928) 532-8386
Mailing address
5171 CUB LAKE RD STE B210, SHOW LOW, AZ 85901-7866
(928) 537-9844
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
653561
—
AZ
Enumeration date
12/07/2010
Last updated
11/29/2011
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