Individual provider · Type 1 NPI
Michael Keene Demack, PA C S
Medical Physician Assistant · Payson, AZ
NPI number
1043347313
Active
Practice location
806 S Ponderosa St
Payson, AZ 85541-5541
Fax (928) 468-8625
Mailing address
PO Box 2901
Payson, AZ 85547-2901
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Medicine Physician | 207Q00000X | PA 14934 (CA) |
| Medical Physician Assistant Primary | 363AM0700X | 6422 (AZ) |
Medical Physician Assistant: Definition to come...
5 other providers at this address
- Lone Wolf Medicine, IncMedical Physician Assistant Payson, AZ NPI 1053504225
- Ponderosa Family Care, LLCInternal Medicine Physician Payson, AZ NPI 1144535626
- Durward Lynch, CNPNurse Practitioner Payson, AZ NPI 1699747915
- Lauren Washatka, MDInternal Medicine Physician Payson, AZ NPI 1821651746
- Lynne A. Vigil, N.P.Nurse Practitioner Payson, AZ NPI 1912967704
Other medical physician assistant providers in Payson
About NPI 1043347313
Michael Keene Demack, PA C S's National Provider Identifier is 1043347313, issued on Feb 27, 2007. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Payson, AZ. The record was last updated on Apr 19, 2017.