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Individual

PRAKASH JAYANTHI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3131 E CLARENDON AVE STE 102, PHOENIX, AZ 85016-7069
(602) 253-9168
(602) 251-3126
Mailing address
3131 E CLARENDON AVE STE 102, PHOENIX, AZ 85016-7069
(602) 253-9168
(602) 251-3126

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
01086267A
IN
208600000X
Surgery Physician
4301108382
MI
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
77631
AZ

Other

Enumeration date
07/06/2015
Last updated
10/31/2025
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