1578516555 NPI number — COCHISE EAR NOSE AND THROAT ASSOCIATES PLLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1578516555 NPI number — COCHISE EAR NOSE AND THROAT ASSOCIATES PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COCHISE EAR NOSE AND THROAT ASSOCIATES PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1578516555
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/06/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 93
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SIERRA VISTA
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85636-0093
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
520-458-4919
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
155 CALLE PORTAL
Provider Second Line Business Practice Location Address:
SUITE 600
Provider Business Practice Location Address City Name:
SIERRA VISTA
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85635-2900
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
520-458-4919
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/18/2006

Additional Information

Authorized Official

Authorized Official Last Name:
TERUEL
Authorized Official First Name:
LAWRENCE
Authorized Official Middle Name:
NUNEZ
Authorized Official Title or Position:
MEMBER
Authorized Official Telephone Number:
520-458-4919

Provider Taxonomy Codes

  • Taxonomy code: 207Y00000X , with the licence number:  34998 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2026 www.npivalidator.com