Healthcare Provider Details

I. General information

NPI: 1730856303
Provider Name (Legal Business Name): LEE EVAN RANSOM PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/23/2021
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8435 N PIMA CENTER PKWY
SCOTTSDALE AZ
85258-4638
US

IV. Provider business mailing address

8435 N PIMA CENTER PKWY
SCOTTSDALE AZ
85258-4638
US

V. Phone/Fax

Practice location:
  • Phone: 480-889-1838
  • Fax:
Mailing address:
  • Phone: 480-889-1838
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number9623
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number9623
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: