Provider Demographics
NPI:1902986078
Name:AFFLECK, PAUL J (MD)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:J
Last Name:AFFLECK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3340 NORTH CENTER ST
Mailing Address - Street 2:#800
Mailing Address - City:LEHI
Mailing Address - State:UT
Mailing Address - Zip Code:84043-7406
Mailing Address - Country:US
Mailing Address - Phone:801-990-1911
Mailing Address - Fax:801-990-1912
Practice Address - Street 1:1551 E TANGERINE RD
Practice Address - Street 2:
Practice Address - City:ORO VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85755-6213
Practice Address - Country:US
Practice Address - Phone:520-901-3500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ26426207L00000X
UT5217195-1205207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ442187002Medicaid
WY119309100Medicaid
ID806809000Medicaid
UT2090168OtherUNITED HEALTHCARE
UT77511OtherPEHP
UTQM0000075886OtherALTIUS
UT870545614PJAOtherEDUCATORS MUTUAL
NV100502671Medicaid
UT107022203101OtherIHC
UT828828OtherDESERET MUTUAL
UT99456OtherHEALTHY U
UTTPRA08597OtherMOLINA
UT52171951203001OtherBCBS
UT1502954OtherUMWA
UTG84692Medicare UPIN
UTP00094648Medicare ID - Type UnspecifiedRAILROAD MEDICARE
WY119309100Medicaid