Provider Demographics
NPI:1831370741
Name:GITT, JEFFREY SCOTT (DO)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:SCOTT
Last Name:GITT
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15301 SPECTRUM DR STE 330
Mailing Address - Street 2:
Mailing Address - City:ADDISON
Mailing Address - State:TX
Mailing Address - Zip Code:75001-6462
Mailing Address - Country:US
Mailing Address - Phone:833-686-3349
Mailing Address - Fax:972-499-9210
Practice Address - Street 1:3805 E BELL RD STE 5600
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-2190
Practice Address - Country:US
Practice Address - Phone:833-696-3349
Practice Address - Fax:972-499-9210
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-19
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ20232084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ268806Medicaid
AZC98237Medicare UPIN
AZ268806Medicaid