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Individual

DR. JEFFREY R DESANTO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
350 W. THOMAS AVE, PHOENIX, AZ 85013
(602) 406-6281
Mailing address
11614 N 40TH PL, PHOENIX, AZ 85028-2242
(309) 648-8207

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
036125321
IL
2085R0202X
Diagnostic Radiology Physician
Primary
125046527
IL

Other

Enumeration date
06/09/2007
Last updated
12/26/2024
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