Dwayne St. Jacques Md Pllc
Pediatric Adolescent Medicine
Dwayne St. Jacques Md Pllc is a Phoenix, Arizona based Pediatric center with medical specialization in
Pediatric Adolescent Medicine. Dwayne St. Jacques Md Pllc is doing business as
Azkidsdoc Pediatrics.
It is located at
15215 South 48th Street, Suite 110, Phoenix, Arizona - 85044-9375. They can be contacted on phone at
480-783-8964 and fax number 480-783-8967.
NPI number (Unique professional ID) for Dwayne St. Jacques Md Pllc is
1902370349 which was assigned by NPPES on 18 Jan, 2019 and it was last updated on 18 Jan, 2019.
Dwayne St. Jacques Md Pllc specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.
Complete Profile:
Dwayne St. Jacques Md Pllc basic information including their official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics Adolescent Medicine |
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| Provider Name : | Dwayne St. Jacques Md Pllc |
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| Other Name : | Azkidsdoc Pediatrics |
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Business Address:
Dwayne St. Jacques Md Pllc address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | 15215 South 48th Street, Suite 110
Phoenix, AZ, 85044-9375
United States |
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| Phone Number : | 480-783-8964 |
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| Fax Number : | 480-783-8967 |
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Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
| NPI Number : | 1902370349 |
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| NPI Entity Type : | Organization |
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| First Enrolment Date : | 18 Jan, 2019 |
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| Last Updated On : | 18 Jan, 2019 |
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Authorized Official Details:
Officially authorized person to contact for any management issues or complaints of this organization are as below. Person's position and contact details are as mentioned below.
| Authorized Official Name : | Dwaynemichael St. Jacques |
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| Authorized Official Credential : | M.D. |
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| Official Title or Position : | OWNER/PHYSICIAN |
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| Phone Number : | 480-783-8964 |
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Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Dwayne St. Jacques Md Pllc are as mentioned. Primary taxonomy code for Dwayne St. Jacques Md Pllc is
2080A0000X (Pediatrics Adolescent Medicine).
| Taxonomy Code | Speciality | Primary | License No. | State |
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| 208000000X | Pediatrics | No | | |
| 2080A0000X | Pediatrics Adolescent Medicine | Yes | | |
Legacy Identifiers:
Other legacy medical identifiers of Dwayne St. Jacques Md Pllc such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
| Identifier | Identifier Type | State | Issuer |
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| 424052 | MEDICAID | AZ | |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | 15215 South 48th Street, Suite 110
Phoenix, AZ, 85044-9375
United States |
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| Phone Number : | 480-783-8964 |
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| Fax Number : | 480-783-8967 |
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Business Location:
Patients can refer following map for directions to
Dwayne St. Jacques Md Pllc practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES.