Bangert, Jerry Lee

Bangert, Jerry Lee is an sole proprietor health care provider with primary practice located at 7356 North La Cholla Blvd. , Tucson AZ 85741. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Dermatology, Allopathic & Osteopathic Physicians / Dermatopathology. Allopathic & Osteopathic Physicians / Dermatology is his primary health care specialty. Bangert, Jerry Lee can be contacted via phone (520) 575-1007.

Contact Information

Primary practice address
7356 North La Cholla Blvd. Tucson AZ 85741
Phone: (520) 575-1007
Fax: (214) 596-7422
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 11270 Arizona
Allopathic & Osteopathic Physicians / Dermatopathology 207ND0900X 11270 Arizona

Profile Details

NPI number 1578529855
LBN Legal business name Bangert, Jerry Lee
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 25th, 2006
Last updated Nov 25th, 2013 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1578529855 NPPES
Arizona MEDICAID 263062

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