Individual
REGAN R ALFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
370 E VIRGINIA AVE, STE 100, PHOENIX, AZ 85004-1214
(602) 258-4788
(602) 258-5131
Mailing address
PO BOX 7587, PHOENIX, AZ 85011-7587
(602) 258-4788
(602) 258-5131
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
5805
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
953346
—
AZ
Enumeration date
09/16/2014
Last updated
11/17/2014
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