Underdahl, Jerald P
Underdahl, Jerald P is an individual health care provider with primary practice located at 1331 N 7Th St 100, Phoenix AZ 85006-2754. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Underdahl, Jerald P can be contacted via phone (602) 222-2234.Contact Information
Primary practice address
1331 N 7Th St 100
Phoenix AZ 85006-2754
Phone: (602) 222-2234
Fax: (866) 985-7247
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | 28541 | Arizona |
Profile Details
| NPI number | 1043284581 |
|---|---|
| LBN Legal business name | Underdahl, Jerald P |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 13th, 2006 |
| Last updated | Jun 28th, 2016 - about 9 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1043284581 | NPPES |
| Arizona | MEDICAID | 524513 |
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