Provider Demographics
NPI:1386618965
Name:STEVENS, DAVID L (PA-C)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:L
Last Name:STEVENS
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3499 W 20TH LN
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364-5907
Mailing Address - Country:US
Mailing Address - Phone:928-343-1832
Mailing Address - Fax:
Practice Address - Street 1:3499 W 20TH LN
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-5907
Practice Address - Country:US
Practice Address - Phone:928-343-1832
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2048363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ461559Medicaid
AZ1064210001Medicare PIN
S54956Medicare UPIN
AZ970008058Medicare PIN
AZ461559Medicaid
AZZ77408Medicare PIN