Provider Demographics
NPI:1194972489
Name:FRONCZEK, JULIE M (PAC)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:M
Last Name:FRONCZEK
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 31630
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85751-1630
Mailing Address - Country:US
Mailing Address - Phone:520-784-6200
Mailing Address - Fax:520-784-6109
Practice Address - Street 1:5301 E. GRANT RD.
Practice Address - Street 2:ORTHOPAEDIC BLDG, 1ST FLOOR
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-2805
Practice Address - Country:US
Practice Address - Phone:520-784-6200
Practice Address - Fax:520-784-6109
Is Sole Proprietor?:No
Enumeration Date:2008-08-19
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMPA2012-0064363A00000X
VA0110003083363A00000X
OK1747363A00000X
AZ6341363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMPA2012-0064OtherNEW MEXICO MEDICAL LICENSE
VA0110003083OtherVIRGINIA BOARD OF MEDICINE
OK1747OtherOKLAHOMA LICENSE
AZ6341OtherARIZONA REGULATORY BOARD OF PHYSICIAN ASSISTANTS