DWAYNE ST. JACQUES MD PLLC


Address: 15215 South 48th Street, Suite 110, Phoenix, AZ 85044-9375
Phone: 4807838964

DWAYNE ST. JACQUES MD PLLC (NPI# 1902370349) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1902370349
Entity Type Organization
Organization Name DWAYNE ST. JACQUES MD PLLC
Practice Address 15215 South 48th Street
Suite 110
Phoenix
AZ 85044-9375
Practice Telephone 4807838964
Practice Fax Number 4807838967
Mailing Telephone 4807838964
Mailing Fax Number 4807838967
Enumeration Date 2019-01-18
Last Update Date 2019-01-18
Authorized Official Name MR. DWAYNE MICHAEL ST. JACQUES (OWNER/PHYSICIAN)
Authorized Official Telephone 4807838964
Authorized Official Credential M.D.
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 208000000X Pediatrics Allopathic & Osteopathic Physicians
Y 2080A0000X Pediatrics
Specialization: Adolescent Medicine
Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
AZ 424052 05

Other Provider/Organization Names

Other Name Type Code
AZKidsDoc Pediatrics Doing Business As Name - Organization

Office Location

Street Address 15215 SOUTH 48TH STREET
SUITE 110
City PHOENIX
State AZ
Zip Code 85044-9375

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1023637345 Jamie Roshun Dawson Contractor 13229 S 48th St Apt 3051, Phoenix, AZ 85044 2020-04-16
1548807514 The Horizon Chiropractic Center Clinic/Center 4425 East Agave Road Suite 104, Phoenix, AZ 85044 2019-12-09
1134777634 Elite Therapy of Az Occupational Therapist 15245 S 48th Street, Phoenix, AZ 85044 2019-08-28
1487217584 Vitae Felix Psychologist 5010 E Warner Rd Ste 213, Phoenix, AZ 85044 2019-04-16
1578082392 Karena Janiece Herron Nurse Practitioner 13625 S 48th St Apt 2100, Phoenix, AZ 85044 2017-09-13
1053847319 Amanda Girardi Dentist 4726 E Verbena Dr, Phoenix, AZ 85044 2017-05-05
1518402593 Janet Swift Counselor 10201 South 51st Street; Suite 130, Phoenix, AZ 85044 2016-12-29
1588074876 Suzanne Morris Nurse Practitioner 4802 E. Ray Rd., Ste 23-364, Phoenix, AZ 85044 2014-05-07
1891117974 Dr. Cameron Khavari Pllc Chiropractor 4001 E Mountain Sky Ave Ste 101, Phoenix, AZ 85044 2014-01-09
1316213416 Shyam Sundar Tangri Internal Medicine 13623 S. 45th St, Phoenix, AZ 85044 2012-03-22
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Taxonomy Information

Taxonomy Code 2080A0000X
Grouping Allopathic & Osteopathic Physicians
Classification Pediatrics
Specialization Adolescent Medicine

Taxonomy Definition

A pediatrician who 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.
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) is provided by the American Osteopathic Board of Pediatrics.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1114271798 Kristen Marie Buchanan Pediatrics 4700 N 51st Ave Ste 4, Phoenix, AZ 85031-1237 2012-11-02
1295930980 Mary Ellen Rimsza Pediatrics 518 S 3rd St, Phoenix, AZ 85004-2506 2007-06-20
1508957101 John Curley Pediatrics 4434 N 12th St, Phoenix, AZ 85014-4507 2006-09-27
1780775395 Shannon Forshey Pediatrics 4434 N 12th Street, Phoenix, AZ 85014-1101 2006-09-27
1194816702 Brad Golner Pediatrics 4735 E Union Hills Dr, Phoenix, AZ 85050-3362 2006-09-27
1134473515 Lizzette Pagan Pllc Pediatrics 1823 E Mcdowell Rd, Phoenix, AZ 85006-3052 2012-11-06
1831373562 Agnes Ida Bartha Pediatrics 7010 E Chauncey Ln, Suite 225, Phoenix, AZ 85054-3111 2007-12-17
1497964449 Arizona Pediatric Clinics Pllc Pediatrics 809 E Washington St, Suite 106, Phoenix, AZ 85034-1052 2007-05-22
1053491316 Anthony Nagorka Pediatrics 4434 N 12th Street, Phoenix, AZ 85014-1101 2006-10-17
1801985486 The Phoenix Children's Center, Ltd Pediatrics 5040 N 15th Ave, Ste 104, Phoenix, AZ 85015-3328 2006-10-12
Find all providers in PHOENIX

Competitor

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City PHOENIX
Zip Code 85044

Improve Information

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Dataset Information

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.

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