Provider Demographics
NPI:1316981467
Name:GIDEON, PHILIP A (MD)
Entity type:Individual
Prefix:
First Name:PHILIP
Middle Name:A
Last Name:GIDEON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3099 N CIVIC CENTER PLZ
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-6903
Mailing Address - Country:US
Mailing Address - Phone:480-945-3535
Mailing Address - Fax:480-994-8179
Practice Address - Street 1:3099 N CIVIC CENTER PLZ
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-6903
Practice Address - Country:US
Practice Address - Phone:480-945-3535
Practice Address - Fax:480-994-8179
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2007-11-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ35544207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ35544OtherAZ MEDICAL LICENSE
AZP00344920OtherRAILROAD MEDICARE
AZ2Z4722OtherHEALTHNET
AZ2708028OtherUNITEDHEALTHCARE
AZ7075491OtherAETNA
AZ1147620OtherCIGNA
AZAZ0922520OtherBCBS AZ
AZ1147620OtherCIGNA
AZ35544OtherAZ MEDICAL LICENSE