Organization
SANSON PEDIATRICS, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAYNE ANN SANSON-JARACZEWSKI M.D. (PRESIDENT)
(928) 649-1559
Entity
Organization
Contact information
Practice address
203 S CANDY LN, SUITE 6B, COTTONWOOD, AZ 86326-4120
(928) 649-1559
(928) 649-1427
Mailing address
203 S CANDY LN, SUITE 6B, COTTONWOOD, AZ 86326-4120
(928) 649-1559
(928) 649-1427
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
30834
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
728454
—
AZ
01
—
728454002
APIPA
AZ
Enumeration date
08/23/2007
Last updated
08/23/2007
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