Individual
DR. ERIC A HUETTL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5777 E MAYO BLVD, PHOENIX, AZ 85054-4502
(480) 301-8000
Mailing address
5777 E MAYO BLVD, PHOENIX, AZ 85054-4502
(480) 301-8000
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
22218
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
329707
—
AZ
01
—
86080015085259A024
TRIWEST
AZ
Enumeration date
11/22/2005
Last updated
10/30/2007
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