Individual
PANKAJ M JAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
13555 W MCDOWELL RD, SUITE 203, GOODYEAR, AZ 85395-2624
(623) 512-4390
(623) 512-4391
Mailing address
13555 W MCDOWELL RD STE 302, GOODYEAR, AZ 85395-2629
(623) 512-4390
(623) 512-4139
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
32772
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11266362
CAQH
AZ
01
—
7346552
AETNA
AZ
01
—
7755462
CIGNA
AZ
05
—
869117
—
AZ
01
—
AZ0760380
BLUE CROSS BLUE SHIELD
AZ
Enumeration date
02/11/2006
Last updated
03/07/2025
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