Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 29170 | AZ |
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 29170 | AZ |
NPI | 1528166212 |
---|---|
Provider Name | Eric Anctil |
First Address | Tucson, AZ 85751-1630 |
Second Address | Tucson, AZ 85712-2805 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2006 |
Last Update Date | 07/02/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H47057 | (02) | AZ |