Organization
CRYSTAL CANYON ENT & FACIAL PLASTIC SURGERY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PAMELA A TAYLOR (OFFICE MANAGER)
(928) 774-1873
Entity
Organization
Contact information
Practice address
1340 N RIM DR, FLAGSTAFF, AZ 86001-3111
(928) 774-1873
(928) 774-5525
Mailing address
1340 N RIM DR, FLAGSTAFF, AZ 86001-3111
(928) 774-1873
(928) 774-5525
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
MD3000
AZ
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
Primary
MD3000
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1000074
UNITED HEALTH CARE
AZ
05
—
316762
—
AZ
01
—
AZ0228870
BCBSAZ
AZ
Enumeration date
01/26/2007
Last updated
04/04/2013
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us