Provider Demographics
NPI:1467418699
Name:DENNEY, DOUGLAS (PA-C)
Entity Type:Individual
Prefix:MR
First Name:DOUGLAS
Middle Name:
Last Name:DENNEY
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 1:6120 W BELL RD STE 100
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-3780
Mailing Address - Country:US
Mailing Address - Phone:833-263-3426
Mailing Address - Fax:866-264-4120
Practice Address - Street 1:6120 W BELL RD STE 100
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-3780
Practice Address - Country:US
Practice Address - Phone:833-263-3426
Practice Address - Fax:866-264-4120
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ929515Medicaid
AZ103606Medicare ID - Type Unspecified
AZ929515Medicaid