Provider Demographics
NPI:1295059632
Name:DE FRANCIS, STEVEN CHARLES (PA-C)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:CHARLES
Last Name:DE FRANCIS
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 1:5310 S 22ND WAY
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85040-3402
Mailing Address - Country:US
Mailing Address - Phone:480-241-7564
Mailing Address - Fax:
Practice Address - Street 1:890 W ELLIOT RD
Practice Address - Street 2:SUITE 103
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85233-5102
Practice Address - Country:US
Practice Address - Phone:480-241-7564
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-14
Last Update Date:2014-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5268363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ754510Medicaid
CO22157735Medicaid