Provider Demographics
NPI:1447649710
Name:ENKING, PATRICK JOHN (MS, PA-C)
Entity type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:JOHN
Last Name:ENKING
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Gender:M
Credentials:MS, PA-C
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Mailing Address - Street 1:435 N 5TH ST
Mailing Address - Street 2:NAU PA PROGRAM HSEB C615
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85004-2157
Mailing Address - Country:US
Mailing Address - Phone:602-827-2415
Mailing Address - Fax:
Practice Address - Street 1:435 N 5TH ST
Practice Address - Street 2:NAU PA PROGRAM HSEB C615
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85004-2157
Practice Address - Country:US
Practice Address - Phone:602-827-2415
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-09
Last Update Date:2015-01-09
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant