DEAN D ETTINGER MD PC NPI 1689925711

NPI Information

NPI: 1689925711
Provider Name: DEAN D ETTINGER MD PC
Classification: Pediatrics - 2080A0000X
Entity Type: Organization

Specialization: Adolescent Medicine

Address:
155 CALLE PORTAL
SUITE 200
SIERRA VISTA, AZ
ZIP 85635
Phone: (520) 458-0660
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DEAN D ETTINGER MD PC is an adolescent medicine pediatrics in Sierra Vista, AZ. The provider is a pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. DEAN D ETTINGER MD PC NPI is 1689925711. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

155 CALLE PORTAL
SUITE 200
SIERRA VISTA, AZ
ZIP 85635-900
Phone: (520) 458-0660
Fax: (520) 458-9550

The provider's authorized official is Dean D Ettinger .
The authorized official title is Owner and has the following contact phone number (520) 458-0660.

The enumeration date for this NPI number is 9/28/2012 and was last updated on 9/28/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2080A0000X	Pediatrics	Adolescent Medicine	12142	ARIZONA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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