Individual
LANCE FRANKLIN ROUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
500 W THOMAS RD, SUITE 710, PHOENIX, AZ 85013-4224
(602) 406-5278
(602) 294-5665
Mailing address
FILE 56765, LOS ANGELES, CA 90074-6765
(602) 406-3860
(602) 406-6132
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
44514
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
626473
—
AZ
Enumeration date
05/28/2008
Last updated
08/31/2012
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