Provider Demographics
NPI:1790762714
Name:PAPST, VICTOR B (PA)
Entity Type:Individual
Prefix:MR
First Name:VICTOR
Middle Name:B
Last Name:PAPST
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 E CAREFREE HWY
Mailing Address - Street 2:PMB518
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85085-8839
Mailing Address - Country:US
Mailing Address - Phone:623-581-8437
Mailing Address - Fax:
Practice Address - Street 1:13677 W MCDOWELL RD
Practice Address - Street 2:
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85338-2618
Practice Address - Country:US
Practice Address - Phone:623-882-1500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1440207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ3981220OtherEVERCARE - GROUP #
AZAW1436OtherHEALTHNET - GROUP #
AZ109779Medicaid
AZ109779Medicaid
AZ28200Medicare ID - Type Unspecified