Jaya Hari Maddur MD PC

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

14396 Issued in AZ

Legal business name

JAYA HARI MADDUR MD PC

Practice address

111 El Camino Real
Sierra Vista, AZ 85635-2807

Phone

(520) 459-3850

Fax

(520) 459-3857

NPI assigned

Mar 14, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Jaya Maddur, MD

Title

Owner / President

Phone

(520) 459-3850

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1205452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367452800000",
    "number": "1265603476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 EL CAMINO REAL",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856352807",
            "telephone_number": "520-459-3850",
            "fax_number": "520-459-3857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 EL CAMINO REAL",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856352807",
            "telephone_number": "520-459-3850",
            "fax_number": "520-459-3857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAYA HARI MADDUR MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-14",
        "last_updated": "2013-05-02",
        "status": "A",
        "authorized_official_last_name": "MADDUR",
        "authorized_official_first_name": "JAYA",
        "authorized_official_title_or_position": "OWNER / PRESIDENT",
        "authorized_official_telephone_number": "520-459-3850",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "AZ",
            "license": "14396",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "232017",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Gastroenterology Physician in Sierra Vista, AZ
• Providers in Sierra Vista, AZ by specialty
• Gastroenterology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.