Individual
MR. MITCHELL D ERICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
13677 W MCDOWELL RD, GOODYEAR, AZ 85395-2635
(623) 882-1500
Mailing address
23968 NORTH 83RD LANE, PEORIA, AZ 85383
(623) 935-9328
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
2438
AZ
363A00000X
Physician Assistant
2438
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3981220
EVERCARE
AZ
01
—
453051001
GROUP HEALTH
AZ
05
—
758013
—
AZ
01
—
860373636
HUMANA
AZ
01
—
AW1436
HEALTHNET
AZ
Enumeration date
12/09/2005
Last updated
11/14/2023
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