Provider Demographics
NPI:1952631525
Name:CATALINA EAR, NOSE & THROAT
Entity Type:Organization
Organization Name:CATALINA EAR, NOSE & THROAT
Other - Org Name:THE INSTITUTE FOR BALANCE & DIZZINESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CONTRACTING AND CREDENTIALING
Authorized Official - Prefix:MS
Authorized Official - First Name:CHRISTY
Authorized Official - Middle Name:K
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-990-4616
Mailing Address - Street 1:5910 N LA CHOLLA BLVD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85741-3535
Mailing Address - Country:US
Mailing Address - Phone:520-498-1800
Mailing Address - Fax:520-498-1400
Practice Address - Street 1:6021 N ORACLE RD
Practice Address - Street 2:SUITE 107
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-5332
Practice Address - Country:US
Practice Address - Phone:520-382-0550
Practice Address - Fax:520-498-1400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-05
Last Update Date:2010-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Multi-Specialty
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
Z109628Medicare PIN