Individual
GREGORY SCALLON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
3411 N 5TH AVE STE 209, PHOENIX, AZ 85013-3812
(602) 789-0344
(602) 789-8389
Mailing address
3411 N 5TH AVE STE 209, PHOENIX, AZ 85013-3812
(602) 789-0344
(602) 789-8389
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2563
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
634370
—
AZ
Enumeration date
06/28/2006
Last updated
01/16/2018
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