Provider Demographics
NPI:1164084034
Name:HIASAT, JAMILA G (MD)
Entity type:Individual
Prefix:
First Name:JAMILA
Middle Name:G
Last Name:HIASAT
Suffix:
Gender:F
Credentials:MD
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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:602-933-3937
Practice Address - Fax:602-933-2409
Is Sole Proprietor?:No
Enumeration Date:2019-07-01
Last Update Date:2024-06-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ70431207WX0110X
PALT000826207WX0110X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0110XAllopathic & Osteopathic PhysiciansOphthalmologyPediatric Ophthalmology and Strabismus Specialist