Individual
DR. JACK R CAVALCANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1432 S DOBSON RD, 106, MESA, AZ 85202-4768
(480) 969-3637
(480) 969-6568
Mailing address
1432 S DOBSON RD, 106, MESA, AZ 85202-4768
(480) 969-3637
(480) 969-6568
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
13635
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
120146
MEDICARE PTAN
AZ
05
—
24111701
—
AZ
Enumeration date
02/13/2006
Last updated
04/04/2008
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