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Individual

ALLAN SUCH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
1485 N TURQUOISE DR, SUITE 200, FLAGSTAFF, AZ 86001-1398
(928) 774-7757
(928) 226-3071
Mailing address
1485 N TURQUOISE DRIVE, FLAGSTAFF, AZ 86001
(928) 774-7757
(928) 226-3071

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2653
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
708670
AZ
Enumeration date
06/25/2006
Last updated
09/02/2016
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