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General NPI Number Information
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NPI Number | 1639834989
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Entity Type | Individual
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Provider Name | WHITNEY ELAINE GEORGE PA-C
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Gender | Female
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Dates
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Enumeration Date | 11/02/2021
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Last Update Date | 04/27/2022
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Provider Practice Location Address
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Address Line | 10450 W MCDOWELL RD STE 101
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City | AVONDALE
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State | AZ
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Zip | 85392-4901
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Country | US
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Telephone | 623-935-1000
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Fax | 623-935-1022
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Provider Business Mailing Address
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Address Line | 7024 N 80TH AVE APT 1
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City | GLENDALE
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State | AZ
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Zip | 85303-2317
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Country | US
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Telephone | 575-956-5636
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Fax |
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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 | 8803
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License Number State | AZ
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