Individual provider · Type 1 NPI

Braiden Clark Fairbanks, PA-C

Physician Assistant · Phoenix, AZ

NPI number 1164017679 Active

Practice location

349 E Coronado Rd
Phoenix, AZ 85004-1525

Call (602) 266-5678 Map

Mailing address

253 N Piedra
Mesa, AZ 85207-7561

Other practice locations

  • 13400 E Shea Blvd, Scottsdale, AZ 85259-5499 · (480) 301-8000

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant Primary 363A00000X8690 (AZ)

Physician Assistant: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, orde…

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About NPI 1164017679

Braiden Clark Fairbanks, PA-C's National Provider Identifier is 1164017679, issued on Mar 5, 2021. The primary taxonomy on file is Physician Assistant (363A00000X), and the practice location is in Phoenix, AZ. The record was last updated on Feb 24, 2025.