Wall, Jillian Marie

Wall, Jillian Marie is an individual health care provider with primary practice located at 1919 E Thomas Rd , Phoenix AZ 85016-7710. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Hospitalist. Allopathic & Osteopathic Physicians / Hospitalist is her primary health care specialty. Wall, Jillian Marie can be contacted via phone (602) 933-0777.

Contact Information

Primary practice address
1919 E Thomas Rd Phoenix AZ 85016-7710
Phone: (602) 933-0777
Fax: (602) 933-0755
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X A118542 California
Allopathic & Osteopathic Physicians / Pediatrics 208000000X P9987 Texas
Allopathic & Osteopathic Physicians / Hospitalist 208M00000X 52240 Arizona

Profile Details

NPI number 1326321084
LBN Legal business name Wall, Jillian Marie
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 20th, 2011
Last updated Mar 29th, 2018 - about 8 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 1326321084 NPPES
Texas MEDICAID 337651901
Texas MEDICAID 337651902

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