Provider Demographics
NPI:1720123805
Name:MARCZAK, JAMES (PA-C)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:
Last Name:MARCZAK
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:18275 N 59TH AVE STE 144
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-1253
Mailing Address - Country:US
Mailing Address - Phone:602-843-2300
Mailing Address - Fax:602-843-2310
Practice Address - Street 1:18275 N 59TH AVE STE 138
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-1253
Practice Address - Country:US
Practice Address - Phone:602-843-2300
Practice Address - Fax:602-843-2310
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ1910363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant