Individual
FARTUN A JAMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
815 E JUAN SANCHEZ BLVD, SAN LUIS, AZ 85349
(928) 627-3822
Mailing address
2060 W 24TH ST, YUMA, AZ 85364-6123
(928) 819-8999
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
6792
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
321252
—
AZ
Enumeration date
10/17/2017
Last updated
02/14/2019
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