Altic, John M.
Altic, John M. is an individual health care provider with primary practice located at 888 S Greenfield Rd #101 , Gilbert AZ 85296-4012. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Physician Assistants & Advanced Practice Nursing Providers / Medical. Allopathic & Osteopathic Physicians / Emergency Medicine is his primary health care specialty. Altic, John M. can be contacted via phone (480) 892-1300.Contact Information
Primary practice address
888 S Greenfield Rd #101
Gilbert AZ 85296-4012
Phone: (480) 892-1300
Fax: (480) 507-7477
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | 2502 | Arizona |
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | 2502 | Arizona |
Profile Details
| NPI number | 1124055637 |
|---|---|
| LBN Legal business name | Altic, John M. |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 28th, 2006 |
| Last updated | Jan 11th, 2011 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1124055637 | NPPES |
| Arizona | MEDICAID | 726713 |
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