Individual
JACK M WOLFSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
10585 N TATUM BLVD, STE D135, PARADISE VALLEY, AZ 85253-1073
(480) 535-6844
(480) 535-6845
Mailing address
10585 N TATUM BLVD, STE D135, PARADISE VALLEY, AZ 85253-1073
(480) 535-6844
(480) 535-6845
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
3761
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
060068481
RAILROAD MEDICARE
AZ
01
—
1Z6403
HEALTHNET
AZ
01
—
25-01062
UNITED HEALTHCARE
AZ
05
—
690257
—
AZ
01
—
AZ0714780
BLUE CROSS BLUE SHIELD
AZ
Enumeration date
06/27/2005
Last updated
07/27/2016
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