Active NPI
Stanley W. Coulthard, M.D.
- Otolaryngology Physician
- Tucson, AZ
National Provider Identifier
1336197326
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- 9899
- Practice address
- 1980 W Hospital Dr
Suite 111
Tucson, AZ 85704-7802 - Phone
- (520) 575-1272
- Fax
- (520) 575-1787
- NPI assigned
- May 4, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | 9899 | AZ | Primary |
Addresses
Primary practice location
1980 W Hospital Dr
Suite 111
Tucson, AZ 85704-7802
Mailing address
6565 E Carondelet Dr
Suite 300
Tucson, AZ 85710-2157
Phone (520) 296-8500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 204529 | Medicaid | AZ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9899 | AZ | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tucson E.N.T. Associates, P.C. | Otolaryngology | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Otolaryngology Physician
- Safford, AZ
- NPI 1265616312
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146700800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1336197326",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6565 E CARONDELET DR",
"address_2": "SUITE 300",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857102157",
"telephone_number": "520-296-8500",
"fax_number": "520-733-2389"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1980 W HOSPITAL DR",
"address_2": "SUITE 111",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857047802",
"telephone_number": "520-575-1272",
"fax_number": "520-575-1787"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COULTHARD",
"first_name": "STANLEY",
"middle_name": "W.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "AZ",
"license": "9899",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "204529",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tucson, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.