Individual
DUANE J FENN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
370 E VIRGINIA AVE, 100, PHOENIX, AZ 85004-1214
(602) 258-4788
Mailing address
370 E VIRGINIA AVE, 100, PHOENIX, AZ 85004-1214
(602) 258-4788
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
5853
AZ
Other
Enumeration date
09/09/2014
Last updated
04/28/2017
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