Individual
DR. JASON C DATTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1255 W RIO SALADO PKWY STE 107, TEMPE, AZ 85281-2892
(480) 962-0071
(480) 962-0590
Mailing address
2610 N 3RD ST, STE B, PHOENIX, AZ 85004
(602) 274-7600
(602) 274-7555
Taxonomy
Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
34112
AZ
207XS0117X
Orthopaedic Surgery of the Spine Physician
43082
CO
Other
Enumeration date
03/09/2006
Last updated
02/04/2019
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