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General NPI Number Information
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NPI Number | 1396097580
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Entity Type | Organization
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Legal Business Name | ABOUT FACE- EAR NOSE & THROAT FACIAL PLASTIC SURGERY PC
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Dates
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Enumeration Date | 10/11/2012
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Last Update Date | 02/08/2013
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Provider Practice Location Address
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Address Line | 9767 N 91ST ST # B102
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City | SCOTTSDALE
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State | AZ
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Zip | 85258-5086
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Country | US
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Telephone | 480-314-0100
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Fax | 480-314-1170
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Provider Business Mailing Address
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Address Line | 9767 N 91ST ST # B102
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City | SCOTTSDALE
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State | AZ
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Zip | 85258-5086
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Country | US
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Telephone | 480-314-0100
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Fax | 480-314-1170
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Authorized Official
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Title or Position | PRESIDENT
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Name | ROBERT H WOODS
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Credential | MD
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Telephone | 480-314-0100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207YX0905X
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Taxonomy Name | Otolaryngology/Facial Plastic Surgery Physician
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License Number | AZ22242
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License Number State | AZ
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