Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | 40546 | AZ |
N | 2084N0402X | Child Neurologist | 46828 | MN |
NPI | 1255303236 |
---|---|
Provider Name | Alyx B Porter Umphrey |
First Address | Scottsdale, AZ 85259-5404 |
Second Address | Scottsdale, AZ 85259 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/02/2006 |
Last Update Date | 03/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I15049 | (02) |