Individual provider · Type 1 NPI

Shannon Whitlock, PAC

Medical Physician Assistant · Prescott, AZ

NPI number 1932274578 Active

Practice location

830 Ainsworth Dr
Prescott, AZ 86301-1630

Call (928) 777-5800 Map

Fax (928) 776-0405

Mailing address

801 York St
Manitowoc, WI 54220-4630

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700X10942 (AZ)
Medical Physician Assistant 363AM0700X0110002157 (VA)

Medical Physician Assistant: Definition to come...

13 other providers at this address

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About NPI 1932274578

Shannon Whitlock, PAC's National Provider Identifier is 1932274578, issued on Nov 21, 2006. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Prescott, AZ. The record was last updated on Aug 27, 2026.