Provider Demographics
NPI:1972599066
Name:JAFFE, DAVID F (DPM)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:F
Last Name:JAFFE
Suffix:
Gender:
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6320 W UNION HILLS DR STE 140
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-7172
Mailing Address - Country:US
Mailing Address - Phone:480-347-0844
Mailing Address - Fax:480-347-0885
Practice Address - Street 1:6320 W UNION HILLS DR STE 140
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-7172
Practice Address - Country:US
Practice Address - Phone:480-347-0844
Practice Address - Fax:480-347-0885
Is Sole Proprietor?:No
Enumeration Date:2005-09-23
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0468213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ379992001Medicaid
AZP00307291OtherMEDICARE RAILROAD
AZAZ0402890OtherBLUE CROSS BLUE SHIELD
AZ5672150001Medicare NSC
AZP00307291OtherMEDICARE RAILROAD
U65237Medicare UPIN