Individual
JEFFREY MORITO NIIZAWA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2020 SILVER CREEK RD, SUITE 220, BULLHEAD CITY, AZ 86442-8476
(928) 763-2500
(928) 763-0027
Mailing address
PO BOX 689022, FRANKLIN, TN 37068-9022
(615) 465-7672
(615) 469-6512
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
21760
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
148024
—
AZ
01
—
2Z7711
HEALTH NET OF AZ
AZ
01
—
3520720
CIGNA
AZ
01
—
4402714
AETNA
AZ
Enumeration date
08/01/2006
Last updated
11/30/2021
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