Provider Demographics
NPI:1487694063
Name:SCHNOG, EILEEN MARY (PA-C)
Entity type:Individual
Prefix:MRS
First Name:EILEEN
Middle Name:MARY
Last Name:SCHNOG
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1760 E RIVER RD
Mailing Address - Street 2:SUITE 350
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85718-5877
Mailing Address - Country:US
Mailing Address - Phone:520-519-7775
Mailing Address - Fax:520-519-7910
Practice Address - Street 1:7200 W BELL RD
Practice Address - Street 2:BLDG. A
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-8529
Practice Address - Country:US
Practice Address - Phone:623-487-4822
Practice Address - Fax:623-334-9881
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2012-01-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ1580363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ638304Medicaid
AZS97459Medicare UPIN
AZ146515Medicare PIN
AZ60609Medicare ID - Type Unspecified