Individual
DR. JAIRO DE JESUS CASTROLONDONO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1200 N BEAVER ST, FLAGSTAFF, AZ 86001-3118
(928) 214-2920
(928) 214-2925
Mailing address
1200 N BEAVER ST, PAYER CREDENTIALING, FLAGSTAFF, AZ 86001-3118
(928) 773-2559
(928) 213-6292
Taxonomy
Speciality
Code
Description
License number
State
170100000X
Ph.D. Medical Genetics
—
—
208M00000X
Hospitalist Physician
Primary
42662
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
513757
—
AZ
Enumeration date
01/12/2007
Last updated
12/18/2015
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