Organization
FELDMAN ENT&FACIAL PLASTIC SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACOB STEPHEN FELDMAN MD (MANAGER)
(510) 206-1890
Entity
Organization
Contact information
Practice address
3700 N COLTON RANCH RD, FLAGSTAFF, AZ 86001-9310
(510) 206-1890
Mailing address
3700 N COLTON RANCH RD, FLAGSTAFF, AZ 86001-9310
(510) 206-1890
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
137469
—
AZ
Enumeration date
09/06/2023
Last updated
01/09/2024
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