Provider Demographics
NPI:1679842876
Name:HAIR, DONALD LEE (PA-C)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:LEE
Last Name:HAIR
Suffix:
Gender:M
Credentials:PA-C
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:5281 N 99TH AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85305-3105
Mailing Address - Country:US
Mailing Address - Phone:623-516-8252
Mailing Address - Fax:623-516-8253
Practice Address - Street 1:1704 W ANKLAM RD
Practice Address - Street 2:SUITE 108
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85745-2656
Practice Address - Country:US
Practice Address - Phone:623-516-8252
Practice Address - Fax:623-516-8253
Is Sole Proprietor?:No
Enumeration Date:2011-12-19
Last Update Date:2015-07-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ5062363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ5062Other5062-AZ PA LICENSE