Individual
MICK GENE DRAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1515 S 20TH AVE, SAFFORD, AZ 85546-4009
(928) 348-1370
(928) 348-1375
Mailing address
1515 S 20TH AVE, SAFFORD, AZ 85546-4009
(928) 348-1370
(928) 348-1375
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2585
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
639354
AHCCCS
AZ
Enumeration date
05/04/2006
Last updated
01/27/2012
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