Individual
DON B. HEADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
500 W THOMAS RD, SUITE 900, PHOENIX, AZ 85013-4224
(602) 406-3540
(602) 406-7186
Mailing address
FILE 56765, LOS ANGELES, CA 90074-6765
(602) 406-3860
(602) 406-6132
Taxonomy
Speciality
Code
Description
License number
State
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
Primary
22079
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
165151
—
AZ
01
—
AZ0779380
BLUE CROSS BLUE SHIELD
AZ
01
—
P00452179
MEDICARE RAILROAD
AZ
Enumeration date
10/06/2005
Last updated
05/14/2012
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