David Lawrence Eldredge, M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

42612 Issued in AZ

Practice address

635 East Baseline Road
Phoenix, AZ 85042-6551

Phone

(602) 243-7277

Fax

(602) 243-5019

NPI assigned

Aug 5, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mountain Park Health Center

  • Federally Qualified Health Center (FQHC)
  • Phoenix, AZ
  • NPI 1669878567
  NPD (past)
• Mountain Park Health Center - Dental

  • Federally Qualified Health Center (FQHC)
  • Phoenix, AZ
  • NPI 1710146188
  NPD (past)

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322524800000",
    "number": "1891704425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2702 NORTH 3RD STREET",
            "address_2": "SUITE 4020",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850044608",
            "telephone_number": "602-323-3344",
            "fax_number": "602-323-3496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 EAST BASELINE ROAD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850426551",
            "telephone_number": "602-243-7277",
            "fax_number": "602-243-5019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELDREDGE",
        "first_name": "DAVID",
        "middle_name": "LAWRENCE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2011-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NH",
            "license": "6210",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "AZ",
            "license": "42612",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30006343",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "482873",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emily Elcsisin
• Paige Emily Elder, MS
• Tanzola Z Elder
• Elder'S Ranch by Carla, LLC
• Eldercareplanningpartners Dba Right at Home
• Tina Michelle Eldrige
• Eleanor Health Professional TX, PLLC
• Electric Mobility Corporation
• Electronic Caregiver Inc.
• Elegant Smiles

• Obstetrics & Gynecology Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Obstetrics & Gynecology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2011; 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.