Healthcare Provider Details

I. General information

NPI: 1932312188
Provider Name (Legal Business Name): CAROL J PEAIRS MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2007
Last Update Date: 03/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5901 E VIA DEL CIELO
PARADISE VALLEY AZ
85253-8107
US

IV. Provider business mailing address

PO BOX 30305
PHOENIX AZ
85046-0305
US

V. Phone/Fax

Practice location:
  • Phone: 480-443-9186
  • Fax: 602-971-1706
Mailing address:
  • Phone: 602-971-7073
  • Fax: 602-971-1706

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number15474
License Number StateAZ

VIII. Authorized Official

Name: CAROL PEAIRS
Title or Position: OWNER
Credential: MD
Phone: 602-867-3270