Individual
DR. JACK B QUIGLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
20243
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
054768
—
AZ
01
—
18032746
STATE COMP AZ
AZ
01
—
2004440
CIGNA
AZ
01
—
20243
AZ LICENSE
AZ
01
—
8607474153000
TAX ID
AZ
01
—
AZ0355110
BLUE CROSS BLUE SHIELD AZ
AZ
05
—
P054768
—
AZ
Enumeration date
05/31/2005
Last updated
07/13/2026
Update your record
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