Healthcare Provider Details
I. General information
NPI: 1689158396
Provider Name (Legal Business Name): PHILLIP ASHTON FOSTER PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/18/2018
Last Update Date: 01/20/2026
Certification Date: 01/20/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
500 MARQUETTE AVE NW STE 1200
ALBUQUERQUE NM
87102-5312
US
IV. Provider business mailing address
3825 N LAFAYETTE ST
DENVER CO
80205-3316
US
V. Phone/Fax
- Phone: 866-849-0692
- Fax:
- Phone: 888-908-0553
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363A00000X |
| Taxonomy | Physician Assistant |
| License Number | 9434 |
| License Number State | AZ |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363A00000X |
| Taxonomy | Physician Assistant |
| License Number | 61964 |
| License Number State | CA |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363A00000X |
| Taxonomy | Physician Assistant |
| License Number | PA2776 |
| License Number State | NV |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363A00000X |
| Taxonomy | Physician Assistant |
| License Number | PA16275 |
| License Number State | TX |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363A00000X |
| Taxonomy | Physician Assistant |
| License Number | PA2018-0102 |
| License Number State | NM |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363A00000X |
| Taxonomy | Physician Assistant |
| License Number | 0010-10516 |
| License Number State | NC |
| # 7 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363A00000X |
| Taxonomy | Physician Assistant |
| License Number | 4170 |
| License Number State | TN |
| # 8 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363A00000X |
| Taxonomy | Physician Assistant |
| License Number | 2927 |
| License Number State | OK |
| # 9 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363A00000X |
| Taxonomy | Physician Assistant |
| License Number | 14265679-1206 |
| License Number State | UT |
| # 10 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363A00000X |
| Taxonomy | Physician Assistant |
| License Number | |
| License Number State | |
| # 11 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363A00000X |
| Taxonomy | Physician Assistant |
| License Number | PA0007581 |
| License Number State | CO |
| # 12 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363A00000X |
| Taxonomy | Physician Assistant |
| License Number | PA.PA.61389450 |
| License Number State | WA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone:
