MEDICARE: PHILLIP VEATCH PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	0000	AZ
2	225100000X	Physical Therapist		AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1013390343
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PHILLIP VEATCH PA-C

Provider Business Mailing Address
First Line	:	2034 E SOUTHERN AVE STE O
Second Line	:
City	:	TEMPE
State	:	AZ
Zip	:	85282-7519
Country	:	US
Telephone Number	:	480-400-6225
Fax Number	:	480-718-8709

Provider Business Practice Location Address
First Line	:	2034 E SOUTHERN AVE STE O
Second Line	:
City	:	TEMPE
State	:	AZ
Zip	:	85282-7519
Country	:	US
Telephone Number	:	480-400-6225
Fax Number	:	480-718-8709

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/06/2015
Last Update Date	:	03/16/2026

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Directions to “ PHILLIP VEATCH PA-C” Practice Location

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