Basic Information
| Provider Information | |||||||||
| NPI: | 1780046631 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WARRINGTON | ||||||||
| FirstName: | STEPHANIE | ||||||||
| MiddleName: | DIANA | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4530 E SHEA BLVD STE 180 | ||||||||
| Address2: | |||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850286042 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6022644834 | ||||||||
| FaxNumber: | 6022578319 | ||||||||
| Practice Location | |||||||||
| Address1: | 5750 W THUNDERBIRD RD STE A100 | ||||||||
| Address2: | |||||||||
| City: | GLENDALE | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 853064661 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6029383205 | ||||||||
| FaxNumber: | 6029385799 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/22/2016 | ||||||||
| LastUpdateDate: | 07/28/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/28/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Y00000X | 66160 | AZ | N | Allopathic & Osteopathic Physicians | Otolaryngology | 207YS0123X | 66160 | AZ | N | Allopathic & Osteopathic Physicians | Otolaryngology | Facial Plastic Surgery | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207Y00000X | 0101271992 | VA | Y | Allopathic & Osteopathic Physicians | Otolaryngology |
No ID Information.