Provider Demographics
NPI:1801027453
Name:SHIPP, JOHN CALVIN (PA-C)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:CALVIN
Last Name:SHIPP
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Gender:M
Credentials:PA-C
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Mailing Address - Street 1:261 N ROOSEVELT AVE
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85226-2616
Mailing Address - Country:US
Mailing Address - Phone:480-305-2888
Mailing Address - Fax:480-305-2889
Practice Address - Street 1:3331 E BASELINE RD
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85234-2633
Practice Address - Country:US
Practice Address - Phone:480-545-1100
Practice Address - Fax:480-545-7181
Is Sole Proprietor?:No
Enumeration Date:2009-07-30
Last Update Date:2017-12-04
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Provider Licenses
StateLicense IDTaxonomies
AZ4431363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant