Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 22868 | AZ |
N | 207RA0201X | Internist - Allergy & Immunology | 22868 | AZ |
NPI | 1457335317 |
---|---|
Provider Name | Harry G Teaford III |
First Address | Scottsdale, AZ 85259-5404 |
Second Address | Scottsdale, AZ 85259-5404 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/12/2005 |
Last Update Date | 10/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F96379 | (02) |