Provider Demographics
NPI:1689000648
Name:ALLAN, STEPHEN K (PA-C)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:K
Last Name:ALLAN
Suffix:
Gender:M
Credentials:PA-C
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Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:15425 N GREENWAY HAYDEN LOOP
Mailing Address - Street 2:SUITE A300
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-1204
Mailing Address - Country:US
Mailing Address - Phone:480-607-1124
Mailing Address - Fax:480-607-1087
Practice Address - Street 1:15425 N GREENWAY HAYDEN LOOP
Practice Address - Street 2:SUITE A300
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-1204
Practice Address - Country:US
Practice Address - Phone:480-607-1124
Practice Address - Fax:480-607-1087
Is Sole Proprietor?:No
Enumeration Date:2013-09-23
Last Update Date:2015-02-16
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Provider Licenses
StateLicense IDTaxonomies
AZ5498363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant