Provider Demographics
NPI:1114583291
Name:STRUTHERS, STEVEN K (PA-C)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:K
Last Name:STRUTHERS
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 1:4830 HIGHWAY 260 STE 103
Mailing Address - Street 2:
Mailing Address - City:LAKESIDE
Mailing Address - State:AZ
Mailing Address - Zip Code:85929-5851
Mailing Address - Country:US
Mailing Address - Phone:928-537-8777
Mailing Address - Fax:928-537-1914
Practice Address - Street 1:4830 HIGHWAY 260 STE 103
Practice Address - Street 2:
Practice Address - City:LAKESIDE
Practice Address - State:AZ
Practice Address - Zip Code:85929-5851
Practice Address - Country:US
Practice Address - Phone:928-537-8777
Practice Address - Fax:928-537-1914
Is Sole Proprietor?:No
Enumeration Date:2019-05-14
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant