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General NPI Number Information
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NPI Number | 1013390343
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Entity Type | Individual
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Provider Name | PHILLIP VEATCH PA-C
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Gender | Male
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Dates
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Enumeration Date | 07/06/2015
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Last Update Date | 07/27/2023
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Provider Practice Location Address
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Address Line | 2034 E SOUTHERN AVE STE O
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City | TEMPE
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State | AZ
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Zip | 85282-7519
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Country | US
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Telephone | 480-400-6225
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Fax | 480-718-8709
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Provider Business Mailing Address
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Address Line | 2034 E SOUTHERN AVE STE O
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City | TEMPE
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State | AZ
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Zip | 85282-7519
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Country | US
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Telephone | 480-400-6225
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Fax | 480-718-8709
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0000
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License Number State | AZ
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