Individual
LEIGH PAVLIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4320 E. PRESIDIO STREET, #101, MESA, AZ 85215-3031
(480) 706-9430
(480) 378-2273
Mailing address
5155 E. EAGLE DRIVE, #20730, MESA, AZ 85277-3031
(480) 706-9430
(480) 378-2273
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
5984
AZ
363AM0700X
Medical Physician Assistant
—
AZ
363AS0400X
Surgical Physician Assistant
Primary
5984
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
109236
—
AZ
Enumeration date
02/09/2015
Last updated
04/07/2016
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