| Gavin Ferguson, PA-C | |
|
1515 E Cedar Ave Ste 2b3b4e12, Flagstaff, AZ 86004-1600 | |
| (928) 714-0010 | |
| Not Available |
| Full Name | Gavin Ferguson |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Location | 1515 E Cedar Ave Ste 2b3b4e12, Flagstaff, Arizona |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265943252 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363AM0700X | Physician Assistant - Medical | 6948 (Arizona) | Secondary |
| 363A00000X | Physician Assistant | 6948 (Arizona) | Primary |
| Entity Name | Southwest Behavioral Health Services Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1144384389 PECOS PAC ID: 9739075854 Enrollment ID: O20040225000948 |
| Entity Name | Institute for Liver Health LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1831603505 PECOS PAC ID: 3274898010 Enrollment ID: O20180529002629 |
| Mailing Address | Practice Location Address |
|---|---|
| Gavin Ferguson, PA-C 3331 S Gillenwater Dr, Flagstaff, AZ 86005-8983 Ph: (928) 600-2185 | Gavin Ferguson, PA-C 1515 E Cedar Ave Ste 2b3b4e12, Flagstaff, AZ 86004-1600 Ph: (928) 714-0010 |
Mr. Bruce A Mortensen, PA Physician Assistant Medicare: Medicare Enrolled Practice Location: 2000 S Thompson St, Flagstaff, AZ 86001 Phone: 928-226-6400 Fax: 928-226-6410 |
Corey Allen Carver, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 525 N Switzer Canyon Dr, Flagstaff, AZ 86001 Phone: 928-773-2280 Fax: 928-773-2281 |
Erin H Engel, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 107 E Oak Ave, Flagstaff, AZ 86001 Phone: 928-779-7880 Fax: 928-779-7895 |
Anna Elizabeth Fredenberg, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 525 N Switzer Canyon Dr, Flagstaff, AZ 86001 Phone: 928-773-2280 Fax: 928-773-2281 |
Kelly Michele Czarnecki, PAC Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1490 N Turquoise Dr, Flagstaff, AZ 86001 Phone: 928-774-5074 Fax: 928-774-0884 |
Kimberly Sargent, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 107 E Oak Ave, Flagstaff, AZ 86001 Phone: 928-779-7880 |
Mr. Raymond Wolfgang Lieber, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 107 E Oak Ave, Flagstaff, AZ 86001 Phone: 928-779-7880 Fax: 928-779-7895 |