Crystal Canyon Ent & Facial Plastic Surgery Pc

LBN: Crystal Canyon Ent & Facial Plastic Surgery Pc
Crystal Canyon Ent & Facial Plastic Surgery Pc is an health care organization with primary practice located at 1340 N Rim Dr , Flagstaff AZ 86001-3111. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Allergy & Immunology, Allopathic & Osteopathic Physicians / Otolaryngology/Facial Plastic Surgery. Allopathic & Osteopathic Physicians / Otolaryngology/Facial Plastic Surgery is the primary health care specialty. Crystal Canyon Ent & Facial Plastic Surgery Pc can be contacted via phone (928) 774-1873, or through Taylor, Pamela A via phone (928) 774-1873.

Contact Information

Primary practice address
1340 N Rim Dr Flagstaff AZ 86001-3111
Phone: (928) 774-1873
Fax: (928) 774-5525
Website:
Map and Directions
Authorized official contact:
Name: Taylor, Pamela A
Phone: (928) 774-1873

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Allergy & Immunology 207K00000X MD3000 Arizona
Allopathic & Osteopathic Physicians / Otolaryngology/Facial Plastic Surgery 207YX0905X MD3000 Arizona

Profile Details

NPI number 1285780767
LBN Legal business name Crystal Canyon Ent & Facial Plastic Surgery Pc
DBA Doing business as
Authorized official Taylor, Pamela A
Entity Organization
Organization subpart 1 No
Enumeration date Jan 26th, 2007
Last updated Apr 4th, 2013 - about 12 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1285780767 NPPES
Arizona MEDICAID 316762
Arizona Other 1000074
Arizona Other AZ0228870

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