Individual
DR. JOSE URDANETA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
500 W THOMAS RD STE 500, PHOENIX, AZ 85013-4220
(602) 406-4000
(602) 406-6498
Mailing address
500 W THOMAS RD STE 500, PHOENIX, AZ 85013-4220
(602) 406-4000
(602) 406-6498
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
29964
AZ
2084P0800X
Psychiatry Physician
Primary
29964
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Z137138
MEDICARE PTAN
AZ
Enumeration date
09/19/2006
Last updated
11/30/2018
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