MEDICARE: LAURA MOUNT 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	363A00000X	Physician Assistant	5451	AZ
2	363AS0400X	Surgical Physician Assistant	5451	AZ

General Provider Information

NPI Number	:	1992130991
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURA MOUNT PA-C

Provider Business Mailing Address
First Line	:	7349 N VIA PASEO DEL SUR STE 515-279
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85258-3765
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7349 N VIA PASEO DEL SUR STE 515-279
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85258-3765
Country	:	US
Telephone Number	:	847-942-4833
Fax Number	:

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

Provider Enumeration Date	:	09/09/2013
Last Update Date	:	04/07/2026

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Directions to “ LAURA MOUNT PA-C” Practice Location

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