Provider Demographics
NPI:1962612069
Name:DAVID G CARFAGNO
Entity type:Organization
Organization Name:DAVID G CARFAGNO
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:GIRARD
Authorized Official - Last Name:CARFAGNO
Authorized Official - Suffix:
Authorized Official - Credentials:DM
Authorized Official - Phone:623-399-8606
Mailing Address - Street 1:10133 N 92ND ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-4556
Mailing Address - Country:US
Mailing Address - Phone:623-399-8606
Mailing Address - Fax:623-399-9958
Practice Address - Street 1:10133 N 92ND ST
Practice Address - Street 2:SUITE 102
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-4556
Practice Address - Country:US
Practice Address - Phone:623-399-8606
Practice Address - Fax:623-399-9958
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-23
Last Update Date:2007-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3227207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ80720Medicare PIN