Brekke, Jan H

Brekke, Jan H is an individual health care provider with primary practice located at 5322 W Northern Ave , Glendale AZ 85301-1405. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Brekke, Jan H can be contacted via phone (480) 425-5063.

Contact Information

Primary practice address
5322 W Northern Ave Glendale AZ 85301-1405
Phone: (480) 425-5063
Fax: (623) 915-6924
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 27440 Arizona

Profile Details

NPI number 1083603039
LBN Legal business name Brekke, Jan H
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 20th, 2005
Last updated Jul 8th, 2007 - about 19 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 1083603039 NPPES
Arizona Other 476079 AHCCCS
Arizona Other 28532 AHCCCS

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