Healthcare Provider Details

I. General information

NPI: 1861257248
Provider Name (Legal Business Name): INTEGRITY PAIN AND ANESTHESIA PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2024
Last Update Date: 02/15/2024
Certification Date: 02/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6677 W THUNDERBIRD RD STE G101
GLENDALE AZ
85306-3724
US

IV. Provider business mailing address

7436 E MAIN ST STE 2
MESA AZ
85207-9338
US

V. Phone/Fax

Practice location:
  • Phone: 480-325-9600
  • Fax: 480-493-5336
Mailing address:
  • Phone: 480-325-9600
  • Fax: 480-493-5336

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: AMIT MANU PATEL
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 480-325-9600