OrganizationActive
Dwayne St. Jacques MD PLLC
NPI 1902370349 · Pediatric Adolescent Medicine Physician · Phoenix, AZ
Provider details
- NPI number
- 1902370349
- Entity type
- Organization
- Primary specialty
- Pediatric Adolescent Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Dwayne St. Jacques, Owner/Physician(480) 783-8964
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Pediatrics Physician208000000X
Allopathic & Osteopathic Physicians
Practice location
15215 South 48th Street
Suite 110
Phoenix, AZ 85044-9375
Phone: (480) 783-8964
Fax: (480) 783-8967
Approximate (ZIP-level) locationGet directions
Mailing address
15215 South 48th Street
Phoenix, AZ 85044-9375
Other names (DBA / former)
- Doing business as
- Azkidsdoc Pediatrics
Registry dates
- Enumerated
- 2019-01-18
- Last updated
- 2019-01-18
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.