Basic Information
| Provider Information | |||||||||
| NPI: | 1255508354 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GIEBEL | ||||||||
| FirstName: | STEPHEN | ||||||||
| MiddleName: | JOHN | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1450 S DOBSON RD STE A203 | ||||||||
| Address2: | |||||||||
| City: | MESA | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852024742 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4804569500 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1450 S DOBSON RD | ||||||||
| Address2: | |||||||||
| City: | MESA | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852024712 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4804569500 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/08/2008 | ||||||||
| LastUpdateDate: | 04/27/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/27/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 4301091971 | MI | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 390200000X | 4301091971 | MI | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207P00000X | 44468 | AZ | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.