Provider Demographics
NPI:1528065422
Name:DEARING, JAMES JOSEPH (DO)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:JOSEPH
Last Name:DEARING
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 W UTOPIA RD
Mailing Address - Street 2:STE. 100
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85027-4171
Mailing Address - Country:US
Mailing Address - Phone:602-214-6148
Mailing Address - Fax:602-214-6149
Practice Address - Street 1:19841 N. 27TH AVENUE
Practice Address - Street 2:SUITE 101
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85027-4002
Practice Address - Country:US
Practice Address - Phone:602-942-8512
Practice Address - Fax:602-942-1075
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2013-09-24
Deactivation Date:2006-03-21
Deactivation Code:
Reactivation Date:2006-04-06
Provider Licenses
StateLicense IDTaxonomies
AZ2115207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZC98204Medicare UPIN