Provider Demographics
NPI:1639215890
Name:GILES, KURT BRETT (PA-C)
Entity Type:Individual
Prefix:MR
First Name:KURT
Middle Name:BRETT
Last Name:GILES
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Gender:M
Credentials:PA-C
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Mailing Address - Street 1:4650 E COTTON CENTER BLVD
Mailing Address - Street 2:STE 250
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85040-4806
Mailing Address - Country:US
Mailing Address - Phone:602-892-0915
Mailing Address - Fax:602-926-1326
Practice Address - Street 1:303 N CENTENNIAL WAY
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85201-6733
Practice Address - Country:US
Practice Address - Phone:480-649-3111
Practice Address - Fax:480-272-8945
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2017-03-30
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Provider Licenses
StateLicense IDTaxonomies
AZ2834363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant