Healthcare Provider Details

I. General information

NPI: 1790781250
Provider Name (Legal Business Name): FRANKLYN R GERGITS III D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2005
Last Update Date: 06/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8573 E PRINCESS DR # B111
SCOTTSDALE AZ
85255-7819
US

IV. Provider business mailing address

9279 E MOUNTAIN SPRING RD
SCOTTSDALE AZ
85255-6608
US

V. Phone/Fax

Practice location:
  • Phone: 480-525-8999
  • Fax: 480-999-4929
Mailing address:
  • Phone: 570-490-8819
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberOS008222L
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number007227
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: