Individual
LUCAS KAARSBERG ANDERSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MMS,PA-C
Contact information
Practice address
1635 E MYRTLE AVE, PHOENIX, AZ 85020-5556
(602) 944-2900
Mailing address
1635 E MYRTLE AVE, STE 400, PHOENIX, AZ 85020-5514
(317) 224-4669
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
8782
AZ
Other
Enumeration date
09/16/2021
Last updated
05/04/2022
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