Basic Information
Provider Information
NPI: 1386068856
EntityType: 2
ReplacementNPI:  
OrganizationName: JEM HEALTH, LLC
LastName:  
FirstName:  
MiddleName:  
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Credential:  
OtherOrganizationName:  
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Mailing Information
Address1: 15210 N SCOTTSDALE RD STE 210
Address2:  
City: SCOTTSDALE
State: AZ
PostalCode: 852548127
CountryCode: US
TelephoneNumber: 4803314222
FaxNumber:  
Practice Location
Address1: 15210 N SCOTTSDALE RD STE 210
Address2:  
City: SCOTTSDALE
State: AZ
PostalCode: 852548127
CountryCode: US
TelephoneNumber: 4803314222
FaxNumber:  
Other Information
ProviderEnumerationDate: 02/04/2014
LastUpdateDate: 02/04/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
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ProviderGenderCode:  
AuthorizedOfficialLastName: SIEFFERT
AuthorizedOfficialFirstName: JAMES
AuthorizedOfficialMiddleName: R
AuthorizedOfficialTitleorPosition: MANAGER
AuthorizedOfficialTelephone: 4803314222
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: DR.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: D.C.
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000X  Y193400000X SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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