Provider Demographics
NPI:1194901801
Name:COMPREHENSIVE ENT, HEAD AND NECK SURGERY, PC
Entity type:Organization
Organization Name:COMPREHENSIVE ENT, HEAD AND NECK SURGERY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RANDALL
Authorized Official - Middle Name:S
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:MD PHD
Authorized Official - Phone:303-798-1309
Mailing Address - Street 1:15 W DRY CREEK CIR
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80120-4427
Mailing Address - Country:US
Mailing Address - Phone:303-798-1309
Mailing Address - Fax:303-798-2319
Practice Address - Street 1:15 W DRY CREEK CIR
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80120-4427
Practice Address - Country:US
Practice Address - Phone:303-798-1309
Practice Address - Fax:303-798-2319
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-11
Last Update Date:2008-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty