Organization
DERMATOLOGY AND PLASTIC SURGERY OF ARIZONA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMIE M MOENSTER D.O. (MEMBER)
(520) 458-1787
Entity
Organization
Contact information
Practice address
150 S CORONADO DR STE 110, SIERRA VISTA, AZ 85635-6352
(520) 458-1787
(520) 458-1519
Mailing address
150 S CORONADO DR STE 110, SIERRA VISTA, AZ 85635-6352
(520) 458-1787
(520) 458-1519
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
006021
AZ
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
—
—
208200000X
Plastic Surgery Physician
006018
AZ
Other
Enumeration date
07/09/2013
Last updated
10/08/2025
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