| Mr Stephen Green, PA-C | |
|
1003 Willow Creek Rd, Prescott, AZ 86301-1641 | |
| (928) 771-5100 | |
| Not Available |
| Full Name | Mr Stephen Green |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Location | 1003 Willow Creek Rd, Prescott, Arizona |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245774397 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | 10126252-1206 (Utah) | Secondary |
| 363A00000X | Physician Assistant | 6741 (Arizona) | Primary |
| Entity Name | Emergency Physicians Integrated Care LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1578598199 PECOS PAC ID: 4284548116 Enrollment ID: O20031115000013 |
| Entity Name | Physician Group of Utah Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1477676930 PECOS PAC ID: 8022032234 Enrollment ID: O20060113000886 |
| Entity Name | Ihc Health Services Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1942325154 PECOS PAC ID: 1850209420 Enrollment ID: O20080610000303 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Stephen Green, PA-C 12000 Big Cottonwood Canyon, Solitude Ski Clinic, Brighton, UT 84121 Ph: Not Available | Mr Stephen Green, PA-C 1003 Willow Creek Rd, Prescott, AZ 86301-1641 Ph: (928) 771-5100 |
Mr. Joseph Paul Maidl, P.A.-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 1998 Prescott Lakes Pkwy Apt 250, Prescott, AZ 86301 Phone: 405-795-7784 |
Heather Buttrum, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 743 Miller Valley Rd, Prescott, AZ 86301 Phone: 928-777-9600 Fax: 855-449-5560 |
Mr. Matthew Alexander Namihas, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 802 Ainsworth Dr, Suite A, Prescott, AZ 86301 Phone: 928-776-0601 Fax: 928-776-0620 |
Shalena Peterson, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 3120 Clearwater Dr, Prescott, AZ 86305 Phone: 928-771-3704 Fax: 928-771-0434 |
Victoria Wood, PA Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 500 N Us Highway 89, Prescott, AZ 86313 Phone: 928-717-7413 |
Mr. Patrick J Mcgrath, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1947 Commerce Center Cir Ste A, Prescott, AZ 86301 Phone: 928-458-5723 Fax: 928-237-1787 |
Nicole Martin, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1090 Commerce Dr, Prescott, AZ 86305 Phone: 480-926-7800 |