Individual
JESSICA DANIELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
350 W THOMAS RD, PHOENIX, AZ 85013-4409
(602) 406-3402
Mailing address
PO BOX 42210, PHOENIX, AZ 85080-2210
(623) 266-7770
(623) 322-4639
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
R70164
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
708206
—
AZ
Enumeration date
01/29/2009
Last updated
08/07/2020
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