Healthcare Provider Details
I. General information
NPI: 1558449900
Provider Name (Legal Business Name): NORTHERN ARIZONA EAR NOSE AND THROAT PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/02/2006
Last Update Date: 04/05/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1300 N RIM DR SUITE B
FLAGSTAFF AZ
86001-3128
US
IV. Provider business mailing address
1300 N RIM DR SUITE B
FLAGSTAFF AZ
86001-3128
US
V. Phone/Fax
- Phone: 928-556-9200
- Fax: 928-556-0336
- Phone: 928-556-9200
- Fax: 928-556-0336
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Y00000X |
| Taxonomy | Otolaryngology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
DANIEL
HOEHLE
DOWNS
Title or Position: PRESIDENT
Credential: MD
Phone: 928-556-9200