Organization
HEAD AND NECK SURGICAL ASSOCIATES, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ELAINE H BUTLAND (OFFICE MANAGER)
(207) 797-5753
Entity
Organization
Contact information
Practice address
1250 FOREST AVE, SUITE 301, PORTLAND, ME 04103-1884
(207) 797-5753
(207) 878-1715
Mailing address
1250 FOREST AVE, SUITE 301, PORTLAND, ME 04103-1884
(207) 797-5753
(207) 878-1715
Taxonomy
Speciality
Code
Description
License number
State
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
111630000
—
ME
01
—
CB0866
MEDICARE RAIL ROAD
ME
Enumeration date
03/28/2006
Last updated
09/30/2009
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