Basic Information
| Provider Information | |||||||||
| NPI: | 1801903778 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SEN T JOU MD PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10632 N SCOTTSDALE RD | ||||||||
| Address2: | STE B365 | ||||||||
| City: | SCOTTSDALE | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852546164 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4806076825 | ||||||||
| FaxNumber: | 4806048133 | ||||||||
| Practice Location | |||||||||
| Address1: | 5620 W THUNDERBIRD RD | ||||||||
| Address2: | STE B-3 | ||||||||
| City: | GLENDALE | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 853064636 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6027957256 | ||||||||
| FaxNumber: | 6027957257 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/24/2006 | ||||||||
| LastUpdateDate: | 09/16/2016 | ||||||||
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| AuthorizedOfficialLastName: | JOU | ||||||||
| AuthorizedOfficialFirstName: | SEN | ||||||||
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| AuthorizedOfficialTitleorPosition: | MD | ||||||||
| AuthorizedOfficialTelephone: | 4806076825 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RI0200X | 19518 | AZ | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Infectious Disease |
ID Information
| ID | Type | State | Issuer | Description | 19518 | 01 | AZ | LICENSE | OTHER |