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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 13 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1124055637 NPPES
Arizona MEDICAID 726713

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