NPI 1700125796 GARRETT R PENTON PA-C LUKE AFB AZ. Find Phone Number, Address, Contact details of medical healthcare providers | NPI Number Lookup

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Garrett R Penton - NPI: 1700125796

National Provider Identifier (NPI) is a 10-digit identification number which is issued to health care providers by the Centers for Medicare and Medicaid Services (CMS) in the United States(US). The NPI is introduced to replace of UPIN (unique provider identification number) and now NPI is the only required identifier for Medicare services, and NPI is also used by commercial healthcare insurers and by other payers.

Doctor Name: GARRETT R PENTON
NPI Number: 1700125796
Entity Type Code: Individual (1)
Gender: M
Credentials: PA-C
License Number: 1111519
Business Practice Address: 7219 N Litchfield Rd
56 Medical Group Luke Afb, AZ - 853091529
Business Phone Number: 6238563130
Business Fax Number:
Mailing Address: 7219 N Litchfield Rd, 56 Medical Group
LUKE AFB
State: AZ
Postal Code: 853091529
Phone Number: 6238562834
Fax Number: 6238569635
NPI Enumeration Date: 02/11/2013
NPI Last Update Date: 04/19/2016
Replacement NPI: 0
NPI Deactivation Date:
NPI Reactivation Date:

Taxonomy Information:

Healthcare Provider Taxonomy: 363AM0700X
License Number: 1111519
Healthcare Provider Taxonomy:
(Secondary)
Y
State:
Taxonomy Type: Physician Assistants & Advanced Practice Nursing Providers
Taxonomy Classification: Physician Assistant
Taxonomy Specialization: Medical
Taxonomy Definition:


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