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General NPI Number Information
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NPI Number | 1528484862
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Entity Type | Individual
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Provider Name | ELISABETH LEHIGH MIDDLETON PA-C
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Gender | Female
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Dates
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Enumeration Date | 03/11/2014
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Last Update Date | 07/31/2021
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Provider Practice Location Address
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Address Line | 3931 E CAMELBACK RD
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City | PHOENIX
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State | AZ
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Zip | 85018-2609
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Country | US
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Telephone | 602-687-7858
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Fax |
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Provider Business Mailing Address
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Address Line | 3130 E BASELINE RD STE 105
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City | MESA
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State | AZ
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Zip | 85204-7290
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Country | US
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Telephone | 480-539-0204
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Fax | 480-558-4922
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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 | 5651
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License Number State | AZ
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