Individual
MR. ALEXANDER JONATHON STARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS
Contact information
Practice address
14719 W GRAND AVE, SURPRISE, AZ 85374-7203
(623) 832-9355
Mailing address
14719 W GRAND AVE, SURPRISE, AZ 85374-7203
(623) 832-9355
Taxonomy
Speciality
Code
Description
License number
State
174H00000X
Health Educator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
262957251
SENIOR HMOS
AZ
05
—
262957251
—
AZ
Enumeration date
07/05/2019
Last updated
07/05/2019
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