Provider Demographics
NPI:1801265632
Name:KOOS, ALFRED F JR (PA-C)
Entity type:Individual
Prefix:
First Name:ALFRED
Middle Name:F
Last Name:KOOS
Suffix:JR
Gender:M
Credentials:PA-C
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Mailing Address - Street 1:7649 E PINNACLE PEAK RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-6295
Mailing Address - Country:US
Mailing Address - Phone:602-266-2272
Mailing Address - Fax:602-266-2927
Practice Address - Street 1:7649 E PINNACLE PEAK RD
Practice Address - Street 2:SUITE 100
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-6295
Practice Address - Country:US
Practice Address - Phone:602-266-2272
Practice Address - Fax:602-266-2927
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-22
Last Update Date:2016-02-26
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Provider Licenses
StateLicense IDTaxonomies
AZ6118363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical