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Individual

MR. JAMES EDWARD EDMOND JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
287 E HUNT HWY, SUITE 105, SAN TAN VALLEY, AZ 85143-5095
(480) 677-8282
(480) 677-8283
Mailing address
4600 S MILL AVE, STE 280, TEMPE, AZ 85282-6850
(480) 305-2888
(480) 305-2889

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
11580
MN
363AM0700X
Medical Physician Assistant
Primary
6653
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1059048
NCCPA
MN
Enumeration date
07/24/2014
Last updated
04/05/2017
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