Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 60467 | AZ |
N | 207Y00000X | Otolaryngologist (ENT Doctor) | E-11307 | AR |
Y | 207YP0228X | Pediatric Otolaryngology | 60467 | AZ |
NPI | 1093152951 |
---|---|
Provider Name | Austin N Dehart |
First Address | Phoenix, AZ 85018-2327 |
Second Address | Phoenix, AZ 85006-1462 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2013 |
Last Update Date | 10/12/2020 |