MICHAEL M ETZL JR. (NPI# 1285697490) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285697490 |
| Entity Type | Individual |
| Full Name | MICHAEL M ETZL JR. |
| Credential | M.D. |
| Practice Address |
1919 E Thomas Rd Phoenix AZ 85016-7710 |
| Mailing Address |
1919 E Thomas Rd Bldg 2108, Suite 101 Phoenix AZ 85016-7710 |
| Practice Telephone | 6025460920 |
| Practice Fax Number | 6025460276 |
| Mailing Telephone | 6025128029 |
| Mailing Fax Number | 6025128161 |
| Enumeration Date | 2006-04-10 |
| Last Update Date | 2013-01-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0207X |
Pediatrics Specialization: Pediatric Hematology-Oncology |
14377 | AZ | Allopathic & Osteopathic Physicians |
| Street Address |
1919 E THOMAS RD |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85016-7710 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538162953 | Richard N Southard | Pediatrics | 1919 E Thomas Rd, Phoenix, AZ 85016-7710 | 2005-05-31 |
| 1265049472 | Chelsea Agricola | Nurse Practitioner | 1919 E Thomas Rd, Phoenix, AZ 85016-7710 | 2020-09-30 |
| 1871109686 | Madeline Rose Mcnamee | Audiologist | 1919 E Thomas Rd, Phoenix, AZ 85016-7710 | 2020-09-17 |
| 1699380212 | Lindsey N Manz | Dietitian, Registered | 1919 E Thomas Rd, Phoenix, AZ 85016-7710 | 2020-09-10 |
| 1376156331 | Jena Paige Buck | Occupational Therapist | 1919 E Thomas Rd, Phoenix, AZ 85016-7710 | 2020-08-28 |
| 1386257244 | Alia Torfa | Registered Nurse | 1919 E Thomas Rd, Phoenix, AZ 85016-7710 | 2020-08-28 |
| 1336751999 | Cassandra E Martinez | Registered Nurse | 1919 E Thomas Rd, Phoenix, AZ 85016-7710 | 2020-08-17 |
| 1811508708 | Clara A Hart | Nurse Practitioner | 1919 E Thomas Rd, Phoenix, AZ 85016-7710 | 2020-08-13 |
| 1811505571 | Daniela M Giralt | Nurse Practitioner | 1919 E Thomas Rd, Phoenix, AZ 85016-7710 | 2020-07-20 |
| 1902424179 | Soren B Mickelsen | Speech-Language Pathologist | 1919 E Thomas Rd, Phoenix, AZ 85016-7710 | 2020-07-13 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851992705 | Heatheranne Baker-oldfield | Counselor | 2415 E Camelback Rd Ste 700, Phoenix, AZ 85016 | 2020-11-06 |
| 1780215681 | Sip Home Systems - Mesa LLC | Home Health | 24th At Camelback, 2375 E. Camelback Rd., Suite 600, Phoenix, AZ 85016 | 2020-01-29 |
| 1760945588 | Wei Wei | Student in an Organized Health Care Education/Training Program | Phoenix Children's Hospital 1919 E. Thomas Rd., Phoenix, AZ 85016 | 2019-04-09 |
| 1942765623 | Grace Hatfield | Dietitian, Registered | Phoenix Childrens Hospital 1919 E Thomas Rd, Phoenix, AZ 85016 | 2019-02-06 |
| 1861977027 | Dawn Yvette Lima | Occupational Therapy Assistant | 3128 E Cheery Ln, Phoenix, AZ 85016 | 2018-10-03 |
| 1720583685 | Kristin Pauline Hicklin | Registered Nurse | 2930 E Camelback Rd Ste 100, Phoenix, AZ 85016 | 2018-03-24 |
| 1588181622 | Taness Eyre Billington | Pharmacist | 1625 E. Camelback Rd., Phoenix, AZ 85016 | 2017-08-29 |
| 1093239048 | Emma Ross | Psychologist | 1919 E Thomas Rd Bldg 4th, Phoenix, AZ 85016 | 2017-08-01 |
| 1609396985 | Mohammed Waseemuddin | Student in an Organized Health Care Education/Training Program | Phoenix Children's Hospital, 1919 E Thomas Rd, Phoenix, AZ 85016 | 2017-06-27 |
| 1144777632 | Amanda Mazerall | Occupational Therapist | 4333 N 24th Street, Apartment 223, Phoenix, AZ 85016 | 2016-09-01 |
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| Taxonomy Code | 2080P0207X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Hematology-Oncology |
| A pediatrician trained in the combination of pediatrics, hematology and oncology to recognize and manage pediatric blood disorders and cancerous diseases. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) was provided by the American Osteopathic Board of Pediatrics. The Certification is no longer offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467863902 | Daniel Julien | Pediatrics | 1919 E Thomas Rd, Phoenix, AZ 85016-7710 | 2014-05-19 |
| 1962764860 | Priscila Badia Alonso | Pediatrics | 1919 E Thomas Rd, Phoenix, AZ 85016-7710 | 2012-06-15 |
| 1902122120 | Pablo Andres Angulo | Pediatrics | 2601 E Roosevelt St, Phoenix, AZ 85008-4973 | 2010-04-13 |
| 1558523175 | Amy Rosenfeld | Pediatrics | 1919 E Thomas Rd, Bldg C, Room 2240, Phoenix, AZ 85016-7710 | 2008-06-25 |
| 1548296700 | Dana Beth Salzberg | Pediatrics | 1919 E Thomas Rd, Phoenix, AZ 85016-7710 | 2006-06-22 |
| 1609839844 | Michael M Henry | Pediatrics | 1919 E Thomas Rd, Phoenix, AZ 85016-7710 | 2006-04-10 |
| 1508829938 | Jessica L Boklan | Pediatrics | 1919 E Thomas Rd, Phoenix, AZ 85016-7710 | 2006-04-07 |
| 1073573200 | Terry S Wood | Pediatrics | 1919 E Thomas Rd, Phoenix, AZ 85016-7710 | 2006-03-23 |
| 1528027281 | Dale A Singer | Pediatrics | 1919 E Thomas Rd, Bldg B, Phoenix, AZ 85016-7710 | 2006-03-21 |
| 1699734434 | Masayo Watanabe | Pediatrics | 1919 E Thomas Rd, Phoenix, AZ 85016-7710 | 2006-03-21 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.