Healthcare Provider Details

I. General information

NPI: 1992017271
Provider Name (Legal Business Name): ERBA CARSKADDEN DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2010
Last Update Date: 12/13/2020
Certification Date: 12/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3700 W HIGHWAY 89A
SEDONA AZ
86336-4937
US

IV. Provider business mailing address

120 NORTHVIEW RD STE 1
SEDONA AZ
86336-5581
US

V. Phone/Fax

Practice location:
  • Phone: 928-204-4100
  • Fax:
Mailing address:
  • Phone: 928-527-4325
  • Fax: 928-527-4327

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number006825
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS015913
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: