Provider Demographics
NPI:1952343824
Name:PAXTON, DONALD E (MD)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:E
Last Name:PAXTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:DONALD
Other - Middle Name:E
Other - Last Name:PAXTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:202 E EARLL DR STE 450
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85012-2675
Mailing Address - Country:US
Mailing Address - Phone:602-241-9500
Mailing Address - Fax:602-241-9552
Practice Address - Street 1:202 E EARLL DR
Practice Address - Street 2:SUITE 450
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85012-2634
Practice Address - Country:US
Practice Address - Phone:602-241-9500
Practice Address - Fax:877-796-1477
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2019-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ11356207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZPFP13PAXTD01Medicaid
AZ108749Medicare ID - Type UnspecifiedMEDICARE IDENTIFIER