Provider Demographics
NPI:1215929971
Name:SCHWARTZ, DOUGLAS JAMES (MD)
Entity type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:JAMES
Last Name:SCHWARTZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3020 E CAMELBACK RD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-2848
Mailing Address - Country:US
Mailing Address - Phone:602-229-1900
Mailing Address - Fax:602-257-0810
Practice Address - Street 1:1300 N 12TH ST
Practice Address - Street 2:SUITE 522
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85006-2848
Practice Address - Country:US
Practice Address - Phone:602-229-1900
Practice Address - Fax:602-257-0810
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-18
Last Update Date:2017-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ16736174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ0630251OtherAETNA HEALTH PLAN
AZ100002420OtherRAIL ROAD MEDICARE
AZ1383550-005OtherCIGNA HEALTH PLAN
AZ29-00113OtherUNITED HEALTHCARE
AZAZ0320000OtherBLUECROSS BLUESHIELD
AZ295354OtherAHCCCS
AZAZ0320000OtherBLUECROSS BLUESHIELD
AZZMD16736Medicare PIN