Healthcare Provider Details

I. General information

NPI: 1184932782
Provider Name (Legal Business Name): STEVEN J. LOCNIKAR D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2010
Last Update Date: 04/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11390 E VIA LINDA 103
SCOTTSDALE AZ
85259-4075
US

IV. Provider business mailing address

11390 E VIA LINDA 103
SCOTTSDALE AZ
85259-4075
US

V. Phone/Fax

Practice location:
  • Phone: 480-219-0055
  • Fax: 480-219-0330
Mailing address:
  • Phone: 480-219-0055
  • Fax: 480-219-0330

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number005284
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code207YS0123X
TaxonomyFacial Plastic Surgery Physician
License Number005284
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: