Individual
MR. JAMES HENNESSY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
8705 E MCDOWELL RD, SCOTTSDALE, AZ 85257-3909
(480) 882-4545
(480) 405-8929
Mailing address
907 KEMPER DR, MANSFIELD, TX 76063-3708
(619) 905-6330
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9186
AZ
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
163742
—
AZ
Enumeration date
06/09/2022
Last updated
04/15/2024
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