NPI 1114320959

Derek B Carpenter, PAC

Practitioner Medical Physician Assistant Casa Grande, AZ

Practice location

Address: 865 N Arizola Rd, Casa Grande, AZ 85122
Phone: (520) 836-3446
Mailing address: PO Box 10097, Casa Grande, AZ 85130-0020

Registered specialties

Medical Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363AM0700X Licence 5816 (AZ)

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Registry record

NPI: 1114320959
Entity type: Individual
Sex (as registered): Male
NPI issued: 8 Oct 2014
Record last updated: 18 May 2018

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.