Provider Demographics
NPI:1407828528
Name:NETZ, DAVID O (PA-C)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:O
Last Name:NETZ
Suffix:
Gender:M
Credentials:PA-C
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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 1:4731 S WHITE MOUNTIAN RD
Practice Address - Street 2:
Practice Address - City:SHOW LOW
Practice Address - State:AZ
Practice Address - Zip Code:85901
Practice Address - Country:US
Practice Address - Phone:928-537-8777
Practice Address - Fax:928-537-1914
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-02
Last Update Date:2023-06-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ3013363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical