Healthcare Provider Details
I. General information
NPI: 1770852600
Provider Name (Legal Business Name): VALLEY ENT, PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/21/2011
Last Update Date: 05/11/2022
Certification Date: 05/11/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
395 N SILVERBELL RD SUITE 201
TUCSON AZ
85745-2675
US
IV. Provider business mailing address
9097 E DESERT COVE AVE STE 200
SCOTTSDALE AZ
85260-6280
US
V. Phone/Fax
- Phone: 520-792-2170
- Fax: 520-792-9702
- Phone: 480-614-5406
- Fax: 480-214-9933
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Y00000X |
| Taxonomy | Otolaryngology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MS.
JULIE
HERNANDEZ
Title or Position: BILLING MANAGER
Credential:
Phone: 480-273-8510