Individual
JASON A RANDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2905 W WARNER RD STE 23, CHANDLER, AZ 85224-1674
(480) 345-2031
(480) 491-2767
Mailing address
2905 W WARNER RD STE 23, CHANDLER, AZ 85224-1674
(480) 345-2031
(480) 491-2767
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3437
AZ
363AM0700X
Medical Physician Assistant
3437
AZ
363AS0400X
Surgical Physician Assistant
3437
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
097774
—
AZ
Enumeration date
05/26/2006
Last updated
07/21/2022
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