Provider Demographics
NPI:1669865283
Name:DIDOMENICO, JOSEPH D (MD)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:D
Last Name:DIDOMENICO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2910 N 3RD AVE # 200
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85013-4434
Mailing Address - Country:US
Mailing Address - Phone:602-406-3181
Mailing Address - Fax:602-264-2417
Practice Address - Street 1:3420 S MERCY RD STE 221
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85297-0424
Practice Address - Country:US
Practice Address - Phone:480-681-7344
Practice Address - Fax:602-294-8297
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-05
Last Update Date:2025-06-03
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Provider Licenses
StateLicense IDTaxonomies
AZ75713207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery