person
Mr. John David Shull JR., PA
Surgical Physician Assistant in Mesa, Arizona
NPI 1114325677

John David Shull JR. is a Surgical Physician Assistant based in Phoenix, AZ and is specialized in Surgical. John David Shull JR. practices in Mesa, AZ and has the professional credentials of PA. The NPI Number for John David Shull JR. is 1114325677 and holds a License No. 5989 (Arizona).

The current practice location address for John David Shull JR. is 1520 S Dobson Rd Ste 217, Mesa, AZ and can be reached out via phone at 480-539-4000 and via fax at 480-833-3040.

Location: 1520 S Dobson Rd Ste 217, Mesa, AZ, 85028-6042
person
Provider Profile Details
NPI Number
1114325677
Provider Name
John David Shull JR.
Credential
PA
Provider Entity Type
Individual
Gender
Male
Address
1520 S Dobson Rd Ste 217, Mesa, AZ, 85028-6042
Phone Number
480-539-4000
Fax Number
480-833-3040
Provider Enumeration Date
12/16/2014
Last Update Date
04/13/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1119977 01 NCCPA
5898 01 AZ STATE LICENSE
institution
Provider Business Practice Location Address Details
Address
1520 S Dobson Rd Ste 217
City
State
Zip
85202-4754
Phone Number
480-539-4000
Fax Number
480-833-3040
person
Provider Business Mailing Address Details
Address
1520 S Dobson Rd Ste 217
City
State
Zip
85202-4754
Phone Number
480-539-4000
Fax Number
480-833-3040
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Surgical
Taxonomy
License No.
5989 (Arizona)
Definition
Definition to come...
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