Individual
LISA BOUCEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
21807 N SCOTTSDALE RD, SCOTTSDALE, AZ 85255
(480) 860-8488
(480) 860-8498
Mailing address
9827 N 95TH ST STE 105, SCOTTSDALE, AZ 85258-4591
(480) 860-8488
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
54432
AZ
Other
Enumeration date
04/28/2014
Last updated
07/18/2019
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