Healthcare Provider Details

I. General information

NPI: 1437780665
Provider Name (Legal Business Name): RYAN JOSEPH HILL-FALKENTHAL PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2020
Last Update Date: 10/29/2021
Certification Date: 10/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1325 N LITCHFIELD RD STE 125
GOODYEAR AZ
85395-1215
US

IV. Provider business mailing address

13203 N 103RD AVE STE H5
SUN CITY AZ
85351-3032
US

V. Phone/Fax

Practice location:
  • Phone: 623-242-1231
  • Fax:
Mailing address:
  • Phone: 623-777-4747
  • Fax: 623-777-4748

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: