Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jason Theobald, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1700249067

Jason Theobald, MD is a Student in an Organized Health Care Education/Training Program in Phoenix, Arizona. Works from 2 locations. Licensed in Arizona.

Licensed in
AZ
In the registry since
2016
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1111 E McDowell Rd
Phoenix, AZ 85006-2612
Phone: (480) 500-2540
Fax: (623) 201-7954
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1000 10th Ave, New York, NY 10019-1147 — (212) 523-4000

Specialties & licences

Emergency Medicine Physician (primary) Taxonomy 207P00000X · Licence 57122 (AZ)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1700249067
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 3, 2016
Last updated in NPPESJune 10, 2019
Mailing address1000 10th Ave, New York, NY 10019-1147

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