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NPI Code Detail

MEDICARE: SWAGATA CHAKRABORTY PA-C

MEDICARE: SWAGATA CHAKRABORTY 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
1207Q00000XFamily Medicine Physician6187AZ

General Provider Information

NPI Number : 1811247026
Entity Type Code : Individual
Provider Name (Legal Business Name) : SWAGATA CHAKRABORTY PA-C
Provider Business Mailing Address
First Line : PO BOX 10097
Second Line :
City : CASA GRANDE
State : AZ
Zip : 85130-0020
Country : US
Telephone Number : 520-836-3446
Fax Number : 520-836-8807
Provider Business Practice Location Address
First Line : 44572 W BOWLIN RD
Second Line :
City : MARICOPA
State : AZ
Zip : 85138-4558
Country : US
Telephone Number : 520-568-2245
Fax Number : 520-568-2316
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/14/2012
Last Update Date : 07/21/2022

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Directions to “ SWAGATA CHAKRABORTY PA-C” Practice Location

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