Individual
SETH E. GILLESPIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1533 E WILLETTA ST, PHOENIX, AZ 85006-2935
(602) 569-3999
(602) 569-3887
Mailing address
1533 E. WILLETTA ST, PHOENIX, AZ 85006
(602) 569-3999
(602) 569-3887
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
6254
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
078353
—
AZ
Enumeration date
10/28/2015
Last updated
07/12/2023
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