Provider Demographics
NPI:1295808962
Name:GREPLING, JAMES M (PAC)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:M
Last Name:GREPLING
Suffix:
Gender:M
Credentials:PAC
Other - Prefix:
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Mailing Address - Street 1:6040 N 43RD AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85301-5488
Mailing Address - Country:US
Mailing Address - Phone:623-931-2221
Mailing Address - Fax:623-934-2849
Practice Address - Street 1:6040 N 43RD AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85301-5488
Practice Address - Country:US
Practice Address - Phone:623-931-2221
Practice Address - Fax:623-934-2849
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ1156363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ380212Medicaid
AZ380212Medicaid
AZ380212Medicaid
AZ61319Medicare PIN