Individual
RICHARD A LEASE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RNFA
Contact information
Practice address
2966 E WARBLER RD, GILBERT, AZ 85297-8145
(480) 223-3015
(480) 782-0299
Mailing address
PO BOX 1533, GILBERT, AZ 85299-1533
(480) 223-3015
(480) 782-0299
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
RN 124747
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AZ0307990
BCBS AZ
AZ
Enumeration date
05/10/2006
Last updated
05/19/2022
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