Individual
MR. JUSTIN C HAZEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2200 E SHOW LOW LAKE RD, SHOW LOW, AZ 85901-7831
(928) 537-4375
Mailing address
2200 E SHOW LOW LAKE RD, SHOW LOW, AZ 85901-7831
(928) 537-4375
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5400
AZ
Other
Enumeration date
05/11/2013
Last updated
05/11/2013
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