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NPI Code Detail

MEDICARE: KATHERINE AZAR HAWORTH PA-C

MEDICARE: KATHERINE AZAR HAWORTH 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
1363A00000XPhysician Assistant3152AZ

General Provider Information

NPI Number : 1265573810
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHERINE AZAR HAWORTH PA-C
Provider Business Mailing Address
First Line : 502 W LAS PALMARITAS DR
Second Line :
City : PHOENIX
State : AZ
Zip : 85021-5535
Country : US
Telephone Number : 602-222-9111
Fax Number : 602-277-5111
Provider Business Practice Location Address
First Line : 5056 N CENTRAL AVE
Second Line :
City : PHOENIX
State : AZ
Zip : 85012-1521
Country : US
Telephone Number : 602-222-9111
Fax Number : 602-277-5111
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/08/2007
Last Update Date : 07/08/2007

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Directions to “ KATHERINE AZAR HAWORTH PA-C” Practice Location

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