Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 22172 | AZ |
N | 207YP0228X | Pediatric Otolaryngology | 22172 | AZ |
N | 207YS0123X | Facial Plastic Surgeon | 22172 | AZ |
N | 207YX0007X | Plastic Surgeon (Head & Neck) | 22172 | AZ |
N | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 22172 | AZ |
NPI | 1487619607 |
---|---|
Provider Name | Dr. Adam L Prawzinsky |
First Address | Phoenix, AZ 85016-5319 |
Second Address | Phoenix, AZ 85016-5319 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2006 |
Last Update Date | 20/07/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1487619607 | BCBS (01) | AZ |
164400 | (05) | AZ |
F76789 | (02) | AZ |