Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | 4162 | AZ |
NPI | 1942292024 |
---|---|
Provider Name | Dr. Brian E Trainor |
First Address | Phoenix, AZ 85083-2219 |
Second Address | Gilbert, AZ 85297-0419 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2005 |
Last Update Date | 03/07/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
920224 | (05) | AZ |
H12109 | (02) |