| Gloria Jean Eagle, PA-C | |
|
1200 W Mohave Rd, Parker, AZ 85344-6349 | |
| (928) 669-7380 | |
| (928) 669-7371 |
| Full Name | Gloria Jean Eagle |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant - Medical |
| Location | 1200 W Mohave Rd, Parker, Arizona |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770543506 | NPI | - | NPPES |
| 158539 | Medicaid | AZ | |
| A20324620 | Other | AZ | BLUE CROSS BLUE SHEILD |
| P00279265 | Other | AZ | RAIL ROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363AM0700X | Physician Assistant - Medical | 1932 (Arizona) | Primary |
| Entity Name | La Paz Regional Hospital Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1053684555 PECOS PAC ID: 1557273356 Enrollment ID: O20031219000694 |
| Mailing Address | Practice Location Address |
|---|---|
| Gloria Jean Eagle, PA-C 400 S California Ave, Parker, AZ 85344-4467 Ph: (928) 669-6151 | Gloria Jean Eagle, PA-C 1200 W Mohave Rd, Parker, AZ 85344-6349 Ph: (928) 669-7380 |
Dr. Gabriel Jose Torres Perez, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1200 W Mohave Rd, Parker, AZ 85344 Phone: 928-669-7380 |
Mrs. Staci Ann Page, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1200 W Mohave Rd, Parker, AZ 85344 Phone: 928-669-7380 Fax: 928-669-7371 |
Jared Daniel Christiansen, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 1200 W Mohave Rd, Parker, AZ 85344 Phone: 928-669-9201 Fax: 928-669-7422 |