Basic Information
| Provider Information | |||||||||
| NPI: | 1447403886 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TOWSLEY | ||||||||
| FirstName: | FRANK | ||||||||
| MiddleName: | C | ||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | P.A. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 698 | ||||||||
| Address2: | |||||||||
| City: | SUPERIOR | ||||||||
| State: | MT | ||||||||
| PostalCode: | 598720698 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4068224278 | ||||||||
| FaxNumber: | 4068224963 | ||||||||
| Practice Location | |||||||||
| Address1: | 2735 SILVER CREEK RD | ||||||||
| Address2: | |||||||||
| City: | BULLHEAD CITY | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 864427924 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9287046785 | ||||||||
| FaxNumber: | 9287046785 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/29/2008 | ||||||||
| LastUpdateDate: | 08/21/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AM0700X | 547 | MT | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical | 363A00000X | 7438 | AZ | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
ID Information
| ID | Type | State | Issuer | Description | 547 | 01 | MT | LICENCE NUMBER | OTHER |