Provider Demographics
NPI:1144265000
Name:AUSTIN MEDICAL CONSULTING LLC
Entity type:Organization
Organization Name:AUSTIN MEDICAL CONSULTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JILL
Authorized Official - Middle Name:SUZANNE
Authorized Official - Last Name:AUSTIN
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:602-418-0961
Mailing Address - Street 1:PO BOX 54811
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85078-4811
Mailing Address - Country:US
Mailing Address - Phone:480-545-2610
Mailing Address - Fax:480-545-2673
Practice Address - Street 1:1325 N FIESTA BLVD
Practice Address - Street 2:SUITE 3
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85233-1609
Practice Address - Country:US
Practice Address - Phone:480-545-2610
Practice Address - Fax:480-545-2673
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Single Specialty