Healthcare Provider Details

I. General information

NPI: 1851027106
Provider Name (Legal Business Name): DANIEL WATKINS AUD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2022
Last Update Date: 07/28/2022
Certification Date: 07/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3805 E BELL RD SUITE 5800
PHOENIX AZ
85032
US

IV. Provider business mailing address

3805 E BELL RD SUITE 5800
PHOENIX AZ
85032
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 Code231H00000X
TaxonomyAudiologist
License NumberDA13901
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: