Individual
DR. JALICIA STURDIVANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
15351 W BELL RD, SURPRISE, AZ 85374-4580
(480) 964-2273
(623) 214-5214
Mailing address
3033 N CENTRAL AVE STE 145, PHOENIX, AZ 85012-2808
(480) 964-2273
(623) 974-6721
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
010924
AZ
207QA0505X
Adult Medicine Physician
95609
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201144
—
AZ
Enumeration date
03/31/2020
Last updated
06/20/2024
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