Healthcare Provider Details

I. General information

NPI: 1902056708
Provider Name (Legal Business Name): ROBERT H STOWERS PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/29/2008
Last Update Date: 09/08/2023
Certification Date: 09/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 S DOBSON RD STE 39
CHANDLER AZ
85224-5677
US

IV. Provider business mailing address

600 S DOBSON RD STE 39
CHANDLER AZ
85224-5677
US

V. Phone/Fax

Practice location:
  • Phone: 480-777-5888
  • Fax: 480-777-8996
Mailing address:
  • Phone: 480-777-5888
  • Fax: 480-777-8996

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number4280
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number4280
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: