Healthcare Provider Details

I. General information

NPI: 1558206177
Provider Name (Legal Business Name): JOHN WILLIAM HONEA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: JACK WILLIAM HONEA

II. Dates (important events)

Enumeration Date: 04/21/2026
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 W SAN ANGELO ST
GILBERT AZ
85233-2219
US

IV. Provider business mailing address

2300 W SAN ANGELO ST
GILBERT AZ
85233-2219
US

V. Phone/Fax

Practice location:
  • Phone: 480-619-8684
  • Fax:
Mailing address:
  • Phone: 480-619-8684
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberPTA-015094
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: