Provider Demographics
NPI:1902056708
Name:STOWERS, ROBERT H (PA-C)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:H
Last Name:STOWERS
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 S DOBSON RD STE 39
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-5677
Mailing Address - Country:US
Mailing Address - Phone:480-777-5888
Mailing Address - Fax:480-777-8996
Practice Address - Street 1:600 S DOBSON RD STE 39
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-5677
Practice Address - Country:US
Practice Address - Phone:480-777-5888
Practice Address - Fax:480-777-8996
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-29
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4280363AM0700X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ442901Medicaid