Healthcare Provider Details

I. General information

NPI: 1164287652
Provider Name (Legal Business Name): NORTH VALLEY EAR, NOSE & THROAT ASSOCIATES, P.C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2024
Last Update Date: 02/14/2024
Certification Date: 02/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6320 W UNION HILLS DR STE A170
GLENDALE AZ
85308-7152
US

IV. Provider business mailing address

3805 E BELL RD STE 5800
PHOENIX AZ
85032-2190
US

V. Phone/Fax

Practice location:
  • Phone: 602-688-6500
  • Fax: 602-867-3144
Mailing address:
  • Phone: 602-688-6500
  • Fax: 602-867-3144

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number
License Number State

VIII. Authorized Official

Name: SUSAN M MCGLOIN
Title or Position: PRACTICE MANAGER
Credential:
Phone: 602-688-6500