Healthcare Provider Details

I. General information

NPI: 1134684277
Provider Name (Legal Business Name): STARKMAN FACIAL PLASTIC SURGERY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2019
Last Update Date: 02/04/2023
Certification Date: 02/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8960 E RAINTREE DRIVE SUITE 100
SCOTTSDALE AZ
85260-6679
US

IV. Provider business mailing address

8152 TRAVERSE CT
MONTGOMERY OH
45242-7224
US

V. Phone/Fax

Practice location:
  • Phone: 480-590-2697
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YS0123X
TaxonomyFacial Plastic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: SIDNEY STARKMAN
Title or Position: SURGEON/OWNER
Credential: MD
Phone: 507-226-2427