MEDICARE: GEORGE ANTHONY FUZFA 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	3702	AZ

General Provider Information

NPI Number	:	1609063247
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GEORGE ANTHONY FUZFA PA-C

Provider Business Mailing Address
First Line	:	19401 N CAVE CREEK RD STE 18
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85024-1825
Country	:	US
Telephone Number	:	602-996-0099
Fax Number	:	602-996-1915

Provider Business Practice Location Address
First Line	:	4136 N 75TH AVE STE 116
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85033-3100
Country	:	US
Telephone Number	:	623-247-1234
Fax Number	:

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

Provider Enumeration Date	:	09/27/2007
Last Update Date	:	11/06/2019

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