Provider Demographics
NPI:1588705214
Name:BONE, DAVID S (PA C)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:S
Last Name:BONE
Suffix:
Gender:M
Credentials:PA C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5000 W CHANDLER BLVD BLDG CH-3
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85226-3601
Mailing Address - Country:US
Mailing Address - Phone:480-554-2323
Mailing Address - Fax:480-552-7871
Practice Address - Street 1:5000 W CHANDLER BLVD BLDG CH-3
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85226-3601
Practice Address - Country:US
Practice Address - Phone:480-554-2323
Practice Address - Fax:480-552-7871
Is Sole Proprietor?:No
Enumeration Date:2007-02-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3290363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ20-8823921OtherTAX ID#