Huettl, Eric A
Huettl, Eric A is an individual health care provider with primary practice located at 5777 E Mayo Blvd , Phoenix AZ 85054-4502. He recently has only one registered license in Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology, which is considered as his primary health care specialty. Huettl, Eric A can be contacted via phone (480) 301-8000.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology | 2085R0204X | 22218 | Arizona |
Profile Details
| NPI number | 1861475097 |
|---|---|
| LBN Legal business name | Huettl, Eric A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 22nd, 2005 |
| Last updated | Oct 30th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1861475097 | NPPES |
| Arizona | Other | 86080015085259A024 | TRIWEST |
| Arizona | MEDICAID | 329707 | TRIWEST |
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