Provider Demographics
NPI:1134239080
Name:ALTMAN, JOAN (PAC)
Entity type:Individual
Prefix:
First Name:JOAN
Middle Name:
Last Name:ALTMAN
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Gender:F
Credentials:PAC
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Mailing Address - Street 1:7300 RANCH ROAD 2222
Mailing Address - Street 2:BUILDING 1, STE 200
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78730
Mailing Address - Country:US
Mailing Address - Phone:512-628-0465
Mailing Address - Fax:512-233-2711
Practice Address - Street 1:725 S DOBSON RD
Practice Address - Street 2:SUITE 200
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-5680
Practice Address - Country:US
Practice Address - Phone:480-899-7546
Practice Address - Fax:480-899-7599
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2023-03-20
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Provider Licenses
StateLicense IDTaxonomies
AZ1878363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZS11757Medicare UPIN