Provider Demographics
NPI:1811142888
Name:STURDEVANT, FRANK MOXLEY (MD)
Entity type:Individual
Prefix:
First Name:FRANK
Middle Name:MOXLEY
Last Name:STURDEVANT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1780 W VIA DE ANZA
Mailing Address - Street 2:
Mailing Address - City:GREEN VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85622-4610
Mailing Address - Country:US
Mailing Address - Phone:520-398-5450
Mailing Address - Fax:
Practice Address - Street 1:1780 W VIA DE ANZA
Practice Address - Street 2:
Practice Address - City:GREEN VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85622-4610
Practice Address - Country:US
Practice Address - Phone:520-398-5450
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-18
Last Update Date:2008-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ30146207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology