Healthcare Provider Details

I. General information

NPI: 1497532394
Provider Name (Legal Business Name): NEXT LEVEL PAIN AND SPINE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2023
Last Update Date: 09/13/2023
Certification Date: 09/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4540 E BASELINE RD STE 105
MESA AZ
85206-4616
US

IV. Provider business mailing address

3602 W THOMAS RD STE 4
PHOENIX AZ
85019-4442
US

V. Phone/Fax

Practice location:
  • Phone: 480-272-8944
  • Fax:
Mailing address:
  • Phone: 480-272-8944
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JAMES R SIEFFERT
Title or Position: MANAGER
Credential: DC
Phone: 480-205-9447