person
Jonathan Dale Peckham, PA-C
Medical Physician Assistant in Surprise, Arizona
NPI 1992130884

Jonathan Dale Peckham is a Medical Physician Assistant based in Phoenix, AZ and is specialized in Medical. Jonathan Dale Peckham practices in Surprise, AZ and has the professional credentials of PA-C. The NPI Number for Jonathan Dale Peckham is 1992130884 and holds a License No. 5479 (Arizona).

The current practice location address for Jonathan Dale Peckham is 12361 W Bola Dr Ste 100, Surprise, AZ and can be reached out via phone at 602-641-9486 and via fax at 480-500-8430.

Location: 12361 W Bola Dr Ste 100, Surprise, AZ, 85080-1638
person
Provider Profile Details
NPI Number
1992130884
Provider Name
Jonathan Dale Peckham
Credential
PA-C
Provider Entity Type
Individual
Gender
Male
Address
12361 W Bola Dr Ste 100, Surprise, AZ, 85080-1638
Phone Number
602-641-9486
Fax Number
480-500-8430
Provider Enumeration Date
09/10/2013
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
862609 05 AZ
institution
Provider Business Practice Location Address Details
Address
12361 W Bola Dr Ste 100
City
State
Zip
85378-9021
Phone Number
602-641-9486
Fax Number
480-500-8430
person
Provider Business Mailing Address Details
Address
12361 W Bola Dr Ste 100
City
State
Zip
85378-9021
Phone Number
602-641-9486
Fax Number
480-500-8430
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
License No.
5479 (Arizona)
Definition
Definition to come...
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