NPIMap

Organization Active NPI

Southern Arizona Ear Nose & Throat

  • Otolaryngology Physician
  • Tucson, AZ
National Provider Identifier
1821042904
Registry record updated Jul 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
SOUTHERN ARIZONA EAR NOSE & THROAT
Practice address
1775 W Saint Marys Rd
Suite 211
Tucson, AZ 85745-2696
Phone
(520) 792-2170
Fax
(520) 792-9702
NPI assigned
May 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Brenda Fredricks
Title
Office Manager
Phone
(520) 792-2170

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Y00000X Primary
Otolaryngic Allergy PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207YX0602X
Diagnostic Radiology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2085R0202X
Diagnostic Ultrasound PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2085U0001X

Addresses

Primary practice location

1775 W Saint Marys Rd
Suite 211
Tucson, AZ 85745-2696

Mailing address

1775 W Saint Marys Rd
Suite 211
Tucson, AZ 85745-2696
Phone (520) 792-2170

National Provider Directory

National Provider Directory

Locations

1775 W Saint Marys Rd
Ste 211
Tucson, AZ 85745
Phone (520) 477-7704

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148169600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217376000000",
    "number": "1821042904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1775 W SAINT MARYS RD",
            "address_2": "SUITE 211",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857452696",
            "telephone_number": "520-792-2170",
            "fax_number": "520-792-9702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1775 W SAINT MARYS RD",
            "address_2": "SUITE 211",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857452696",
            "telephone_number": "520-792-2170",
            "fax_number": "520-792-9702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN ARIZONA EAR NOSE & THROAT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-21",
        "last_updated": "2008-07-30",
        "status": "A",
        "authorized_official_last_name": "FREDRICKS",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "520-792-2170"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207YX0602X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Otolaryngology, Otolaryngic Allergy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085U0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "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 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.