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General NPI Number Information
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NPI Number | 1376958017
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Entity Type | Organization
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Legal Business Name | HM COMSTOCK SURGICAL
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Dates
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Enumeration Date | 06/20/2014
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Last Update Date | 06/20/2014
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Provider Practice Location Address
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Address Line | 12947 N BLOOMINGTON LOOP
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City | ORO VALLEY
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State | AZ
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Zip | 85755-8771
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Country | US
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Telephone | 520-296-1206
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Fax |
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Provider Business Mailing Address
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Address Line | 12947 N BLOOMINGTON LOOP
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City | ORO VALLEY
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State | AZ
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Zip | 85755-8771
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | HOWARD COMSTOCK
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Credential | MD
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Telephone | 520-296-1206
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 34193
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License Number State | AZ
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