Provider Demographics
NPI:1609063247
Name:FUZFA, GEORGE ANTHONY (PA-C)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:ANTHONY
Last Name:FUZFA
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 1:19401 N CAVE CREEK RD STE 18
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85024-1825
Mailing Address - Country:US
Mailing Address - Phone:602-996-0099
Mailing Address - Fax:602-996-1915
Practice Address - Street 1:4136 N 75TH AVE STE 116
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85033-3100
Practice Address - Country:US
Practice Address - Phone:623-247-1234
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-27
Last Update Date:2019-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3702363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant