Provider Demographics
NPI:1912471053
Name:FARKAS, KYRA (PA-C)
Entity Type:Individual
Prefix:
First Name:KYRA
Middle Name:
Last Name:FARKAS
Suffix:
Gender:F
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 1:4049 E WILLIAMS FIELD RD STE 101
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85295-3217
Mailing Address - Country:US
Mailing Address - Phone:480-597-9497
Mailing Address - Fax:
Practice Address - Street 1:3615 S ROME ST
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85297-7335
Practice Address - Country:US
Practice Address - Phone:480-771-4400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-11
Last Update Date:2023-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7322363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant