Provider Demographics
NPI:1558449900
Name:NORTHERN ARIZONA EAR NOSE AND THROAT PC
Entity Type:Organization
Organization Name:NORTHERN ARIZONA EAR NOSE AND THROAT PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:HOEHLE
Authorized Official - Last Name:DOWNS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:928-556-9200
Mailing Address - Street 1:1300 N RIM DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86001-3128
Mailing Address - Country:US
Mailing Address - Phone:928-556-9200
Mailing Address - Fax:928-556-0336
Practice Address - Street 1:1300 N RIM DR
Practice Address - Street 2:SUITE B
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86001-3128
Practice Address - Country:US
Practice Address - Phone:928-556-9200
Practice Address - Fax:928-556-0336
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-02
Last Update Date:2011-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ66164Medicare PIN