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NPI Code Detail

MEDICARE: LANCE HUFF PA-C

MEDICARE: LANCE HUFF 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
1363AM0700XMedical Physician Assistant3303AZ

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2Z135579OTHERMEDICARE PTAN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1457415309
Entity Type Code : Individual
Provider Name (Legal Business Name) : LANCE HUFF PA-C
Provider Business Mailing Address
First Line : 1250 S CLEARVIEW AVE STE 100
Second Line :
City : MESA
State : AZ
Zip : 85209-3378
Country : US
Telephone Number : 480-988-9108
Fax Number : 480-813-4460
Provider Business Practice Location Address
First Line : 641 W WARNER RD
Second Line :
City : GILBERT
State : AZ
Zip : 85233-7266
Country : US
Telephone Number : 480-722-9828
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/21/2006
Last Update Date : 04/16/2015

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Directions to “ LANCE HUFF PA-C” Practice Location

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