Organization
CHARLES LEVESQUE PA-C, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES LAURENT LEVESQUE PA-C (PRESIDENT)
(480) 299-4603
Entity
Organization
Contact information
Practice address
1776 N SCOTTSDALE RD UNIT 368, SCOTTSDALE, AZ 85252
(480) 201-5264
Mailing address
PO BOX 368, SCOTTSDALE, AZ 85252-0368
(480) 201-5264
(480) 393-1970
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
1621
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1407005549
INDIVIDUAL NPI NUMBER
AZ
Enumeration date
01/05/2009
Last updated
06/27/2019
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