Rajiv Jetly (NPI# 1861494247, PAC ID# 3779596184) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is INTERNAL MEDICINE.
| Nation Provider ID (NPI) | 1861494247 |
| PAC ID by PECOS | 3779596184 |
| Professional Enrollment ID | I20060801000298 |
| Full Name | Rajiv Jetly |
| Organization Legal Name | SOUTHWEST I.D. AND MEDICAL CLINIC, LC |
| Address |
3235 N Windsong Dr Prescott Valley AZ 86314-1222 |
| Phone Number | 9287723340 |
| Gender | M |
| Credential | MD |
| Graduation Year | 1992 |
| Primary Specialty | INTERNAL MEDICINE |
| Secondary Specialties | INFECTIOUS DISEASE |
| Group Practice PAC ID | 9739192246 |
| Number of Group Practice Members | 2 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 030012 | YAVAPAI REGIONAL MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 3235 N Windsong Dr, Prescott Valley, AZ 86314-1222 | 9287723340 | SOUTHWEST I.D. AND MEDICAL CLINIC, LC |
| Organization Legal Name | SOUTHWEST I.D. AND MEDICAL CLINIC, LC |
| Physicians | 2 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Angela Marie Gonzalez | Nurse Practitioner | Southwest I.d. and Medical Clinic, Lc | 3235 N Windsong Dr, Prescott Valley, AZ 86314-1222 |
| Street Address |
3235 N WINDSONG DR |
| City | PRESCOTT VALLEY |
| State | AZ |
| Zip | 86314-1222 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Angela Marie Gonzalez | Nurse Practitioner | Southwest I.d. and Medical Clinic, Lc | 3235 N Windsong Dr, Prescott Valley, AZ 86314-1222 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| John P Futral | Chiropractic | 8098 E State Route 69, Prescott Valley, AZ 86314 | |
| Thomas E Walls | Nurse Practitioner | Prescott Quick Care, LLC | 3075 N Windsong Dr, Suite A, Prescott Valley, AZ 86314-1208 |
| Scott R Madsen | Physical Therapy | 3075 N Windsong Dr C, Prescott Valley, AZ 86314-1208 | |
| Patricia Louise Benard-walls | Nurse Practitioner | Prescott Quick Care, LLC | 3075 N Windsong Dr, Suite A, Prescott Valley, AZ 86314-1208 |
| Kimberleigh Marie Telling | Nurse Practitioner | Arizona Oncology Associates PC | 3188 N Windsong Dr A, Prescott Valley, AZ 86314-1220 |
| Iyad S Hamarneh | Hematology/oncology | Arizona Oncology Associates PC | 3188 N Windsong Dr A, Prescott Valley, AZ 86314-1220 |
| Allison Kirshner | Nurse Practitioner | Arizona Oncology Associates PC | 3188 N Windsong Dr A, Prescott Valley, AZ 86314-1220 |
| Alan D Langerak | Hematology/oncology | Arizona Oncology Associates PC | 3188 N Windsong Dr A, Prescott Valley, AZ 86314-1220 |
| Jennifer K Stern | Physician Assistant | Davis Orthopaedics | 3237 N Windsong Dr, Prescott Valley, AZ 86314-1222 |
| Sharon L Bettinger | Physician Assistant | Sleep Disorder Center of Prescott Valley LLC | 3259 N Windsong Dr A, Prescott Valley, AZ 86314-1222 |
| Find all physicians in zip 86314 | |||
| City | PRESCOTT VALLEY |
| Zip Code | 86314 |
| Specialty | INTERNAL MEDICINE |
| City + Specialty | PRESCOTT VALLEY + INTERNAL MEDICINE |
Please comment or provide details below to improve the information on Rajiv Jetly.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.