Individual
MR. JEFFREY JAY CARLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1720 MESQUITE AVE, SUITE 100, LAKE HAVASU CITY, AZ 86403
(928) 855-1550
(928) 855-7229
Mailing address
1720 MESQUITE AVE, SUITE 100, LAKE HAVASU CITY, AZ 86403
(928) 855-1550
(928) 855-7229
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
12100
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0856320
BCBS
AZ
05
—
224593
—
AZ
Enumeration date
07/17/2006
Last updated
07/08/2007
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