Provider Demographics
NPI:1992745103
Name:MARCHBANKS, ALAN (PA- C)
Entity type:Individual
Prefix:
First Name:ALAN
Middle Name:
Last Name:MARCHBANKS
Suffix:
Gender:M
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 1:13065 W MCDOWELL RD
Mailing Address - Street 2:STE A105
Mailing Address - City:AVONDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85392-6440
Mailing Address - Country:US
Mailing Address - Phone:623-334-4000
Mailing Address - Fax:623-334-4400
Practice Address - Street 1:7200 W BELL RD
Practice Address - Street 2:A-1
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-8529
Practice Address - Country:US
Practice Address - Phone:623-334-4000
Practice Address - Fax:623-334-4400
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-07
Last Update Date:2016-08-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ2143363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
S82829Medicare UPIN