Provider Demographics
NPI: | 1518347798 |
---|---|
Name: | FURMICK, JULIE-KAY (DO) |
Entity type: | Individual |
Prefix: | |
First Name: | JULIE-KAY |
Middle Name: | |
Last Name: | FURMICK |
Suffix: | |
Gender: | F |
Credentials: | DO |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 3200 E CAMELBACK RD STE 250 |
Mailing Address - Street 2: | |
Mailing Address - City: | PHOENIX |
Mailing Address - State: | AZ |
Mailing Address - Zip Code: | 85018-2327 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 602-933-1814 |
Mailing Address - Fax: | 602-933-8972 |
Practice Address - Street 1: | 1919 E THOMAS RD |
Practice Address - Street 2: | |
Practice Address - City: | PHOENIX |
Practice Address - State: | AZ |
Practice Address - Zip Code: | 85016-7710 |
Practice Address - Country: | US |
Practice Address - Phone: | 602-933-1900 |
Practice Address - Fax: | |
Is Sole Proprietor?: | No |
Enumeration Date: | 2015-06-03 |
Last Update Date: | 2021-04-01 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
AZ | 008413 | 208000000X, 2080P0204X |
NC | 2018-00779 | 208000000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 2080P0204X | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Emergency Medicine |
No | 208000000X | Allopathic & Osteopathic Physicians | Pediatrics |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
AZ | R2497 | Other | ARIZONA BOARD OF OSTEOPATHIC EXAMINERS IN MEDICINE AND SURGERY |