Provider Demographics
NPI:1437781747
Name:MIGDAL, TALOR (PA-C)
Entity Type:Individual
Prefix:
First Name:TALOR
Middle Name:
Last Name:MIGDAL
Suffix:
Gender:F
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 1:111 E DUNLAP AVE
Mailing Address - Street 2:STE I-279
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85020-2807
Mailing Address - Country:US
Mailing Address - Phone:480-331-6721
Mailing Address - Fax:602-296-7738
Practice Address - Street 1:111 E DUNLAP AVE STE 1-279
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85020-7805
Practice Address - Country:US
Practice Address - Phone:480-331-6721
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-05
Last Update Date:2020-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant