Provider Demographics
NPI:1538319801
Name:SEROT, JAMES F (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:F
Last Name:SEROT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2108 E THOMAS RD STE 130
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-0008
Mailing Address - Country:US
Mailing Address - Phone:602-933-3124
Mailing Address - Fax:
Practice Address - Street 1:1919 E THOMAS RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-7710
Practice Address - Country:US
Practice Address - Phone:602-933-4660
Practice Address - Fax:602-933-8945
Is Sole Proprietor?:No
Enumeration Date:2008-09-23
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ56633207L00000X, 207LP3000X
MO2011016905207L00000X, 207LP3000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP3000XAllopathic & Osteopathic PhysiciansAnesthesiologyPediatric Anesthesiology
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILENROLLEDMedicaid
AZ409648Medicaid
MO1538319801Medicaid
IL$$$$$$$$$Medicaid
OK200412090 AMedicaid
AR190675001Medicaid
MI1538319801Medicaid
TNQ005622Medicaid
MO101740087Medicaid