Individual
DR. GEORGE P JOLLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2082 MESQUITE AVE STE 100A, LAKE HAVASU CITY, AZ 86403-6710
(928) 453-2727
(928) 453-2828
Mailing address
PMB-532, 100 WOODS RD, VALHALLA, NY 10595
(347) 294-6206
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
70206
AZ
207RI0011X
Interventional Cardiology Physician
70206
AZ
390200000X
Student in an Organized Health Care Education/Training Program
4301504730
MI
Other
Enumeration date
08/31/2016
Last updated
02/05/2024
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