Healthcare Provider Details

I. General information

NPI: 1871918698
Provider Name (Legal Business Name): NORTHERN ARIZONA SPINE AND PAIN CENTER PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/03/2014
Last Update Date: 12/16/2022
Certification Date: 12/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 S 6TH ST
COTTONWOOD AZ
86326-4237
US

IV. Provider business mailing address

1042 WILLOW CREEK RD STE A101
PRESCOTT AZ
86301-1672
US

V. Phone/Fax

Practice location:
  • Phone: 928-634-5118
  • Fax: 928-634-8522
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ROBERT BROWNSBERGER
Title or Position: OWNER
Credential: M.D.
Phone: 928-458-7343