Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 43004 | AZ |
N | 207Y00000X | Otolaryngologist (ENT Doctor) | A108131 | CA |
Y | 207YP0228X | Pediatric Otolaryngology | 43004 | AZ |
NPI | 1306994595 |
---|---|
Provider Name | Dr. Nathan Clarke Page |
First Address | Phoenix, AZ 85018-2327 |
Second Address | Phoenix, AZ 85006 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/01/2007 |
Last Update Date | 22/06/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
521170 | (05) | AZ |