Most Relevant Information
Provider Data
| NPI Number: | 1003391434 |
| Provider Name: | ETHAN EVERLITH |
| Entity Type: | Individual |
| Taxonomy Code: | 363A00000X |
| Specialty: | Physician Assistant |
| License Number: | 7291 |
Most Important Dates
| Enumeration Date: | 10/02/2018 |
| Last Updated: | 09/20/2024 |
Provider Practice Location
2940 E BANNER GATEWAY DR STE 200
GILBERT
AZ
852342171
Practice Location Phone/Fax
| Phone: | 4809642908 |
| Fax: |
Provider Mailing Location
PO BOX 80217
PHOENIX
AZ
850600217
Provider Mailing Phone/Fax
| Phone: | 6033852115 |
| Fax: | 4804183323 |