Individual
ETHAN EVERLITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2940 E BANNER GATEWAY DR STE 200, GILBERT, AZ 85234-2171
(480) 964-2908
Mailing address
PO BOX 80217, PHOENIX, AZ 85060-0217
(603) 385-2115
(480) 418-3323
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
7291
AZ
363AS0400X
Surgical Physician Assistant
7291
AZ
Other
Enumeration date
10/02/2018
Last updated
11/22/2024
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