Individual
JOEL ALBERTO TERRIQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1200 N BEAVER ST, FLAGSTAFF, AZ 86001-3118
(928) 214-3832
(928) 214-3833
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
207RI0200X
Infectious Disease Physician
Primary
45858
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
713533
—
AZ
Enumeration date
07/19/2010
Last updated
12/09/2015
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