Basic Information
| Provider Information | |||||||||
| NPI: | 1922527266 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DRANEY | ||||||||
| FirstName: | CLINT | ||||||||
| MiddleName: | ADAM | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3313 S KENWOOD LN | ||||||||
| Address2: | |||||||||
| City: | TEMPE | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852825964 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4806885144 | ||||||||
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| Practice Location | |||||||||
| Address1: | 680 E DEUCE OF CLUBS | ||||||||
| Address2: | |||||||||
| City: | SHOW LOW | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 859014829 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9285372777 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/19/2017 | ||||||||
| LastUpdateDate: | 03/17/2018 | ||||||||
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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 | 363A00000X | 6902 | AZ | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.