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Crystal Canyon Ent & Facial Plastic Surgery Pc
Otolaryngology/Facial Plastic Surgery Physician in Flagstaff, Arizona
NPI 1285780767

Crystal Canyon Ent & Facial Plastic Surgery Pc is a Otolaryngology/Facial Plastic Surgery Physician based in Flagstaff, AZ and is specialized in Otolaryngology/Facial Plastic Surgery. Crystal Canyon Ent & Facial Plastic Surgery Pc practices in Flagstaff, AZ. The NPI Number for Crystal Canyon Ent & Facial Plastic Surgery Pc is 1285780767 and holds a License No. MD3000 (Arizona).

The current practice location address for Crystal Canyon Ent & Facial Plastic Surgery Pc is 1340 N Rim Dr, Flagstaff, AZ and can be reached out via phone at 928-774-1873 and via fax at 928-774-5525.

Location: 1340 N Rim Dr, Flagstaff, AZ, 86001-3111
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1285780767
Provider Name
Crystal Canyon Ent & Facial Plastic Surgery Pc
Credential
Provider Entity Type
Organization
Address
1340 N Rim Dr, Flagstaff, AZ, 86001-3111
Phone Number
928-774-1873
Fax Number
928-774-5525
Provider Enumeration Date
01/26/2007
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
316762 05 AZ
1000074 01 AZ UNITED HEALTH CARE
AZ0228870 01 AZ BCBSAZ
institution
Provider Business Practice Location Address Details
Address
1340 N Rim Dr
City
Flagstaff
State
Arizona
Zip
86001-3111
Phone Number
928-774-1873
Fax Number
928-774-5525
person
Provider Business Mailing Address Details
Address
1340 N Rim Dr
City
Flagstaff
State
Arizona
Zip
86001-3111
Phone Number
928-774-1873
Fax Number
928-774-5525
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Allergy & Immunology
Speciality
-
Taxonomy
207K00000X
License No.
MD3000 (Arizona)
Definition
An allergist-immunologist is trained in evaluation, physical and laboratory diagnosis, and management of disorders involving the immune system. Selected examples of such conditions include asthma, anaphylaxis, rhinitis, eczema, and adverse reactions to drugs, foods, and insect stings as well as immune deficiency diseases (both acquired and congenital), defects in host defense, and problems related to autoimmune disease, organ transplantation, or malignancies of the immune system.
person
Provider's Taxonomy Details 2
Type
Allopathic & Osteopathic Physicians
Classification
Otolaryngology
Speciality
Otolaryngology/Facial Plastic Surgery
Taxonomy
207YX0905X
License No.
MD3000 (Arizona)
Definition
An otolaryngologist who specializes in the diagnosis and surgical treatment of head and neck conditions.
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