MEDICARE: MR. JOSHUA RICHARD MARQUIS PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AM0700X	Medical Physician Assistant

General Provider Information

NPI Number	:	1033449988
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JOSHUA RICHARD MARQUIS PA-C

Provider Business Mailing Address
First Line	:	9220 N CENTRAL AVE
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85020-2416
Country	:	US
Telephone Number	:	602-254-7077
Fax Number	:

Provider Business Practice Location Address
First Line	:	9100 N CENTRAL AVE STE A
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85020-2430
Country	:	US
Telephone Number	:	602-254-7077
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/28/2009
Last Update Date	:	09/19/2012

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