Provider Demographics
NPI:1851653125
Name:HOZEY, JESSE BARROWN (PA-C)
Entity Type:Individual
Prefix:
First Name:JESSE
Middle Name:BARROWN
Last Name:HOZEY
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 HILL ST
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:AZ
Mailing Address - Zip Code:85546
Mailing Address - Country:US
Mailing Address - Phone:928-865-1119
Mailing Address - Fax:
Practice Address - Street 1:110 HILL ST
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:AZ
Practice Address - Zip Code:85533
Practice Address - Country:US
Practice Address - Phone:928-865-1119
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-13
Last Update Date:2012-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3650363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical