Healthcare Provider Details

I. General information

NPI: 1689282998
Provider Name (Legal Business Name): SEAN M ORMOND MD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2020
Last Update Date: 05/27/2025
Certification Date: 05/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18205 N 51ST AVE STE 125
GLENDALE AZ
85308-1491
US

IV. Provider business mailing address

18205 N 51ST AVE STE 125
GLENDALE AZ
85308-1491
US

V. Phone/Fax

Practice location:
  • Phone: 602-492-9821
  • Fax: 602-492-9822
Mailing address:
  • Phone: 602-492-9821
  • Fax: 602-492-9822

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State

VIII. Authorized Official

Name: SEAN M ORMOND
Title or Position: OWNER
Credential: MD
Phone: 602-492-9821