Healthcare Provider Details

I. General information

NPI: 1518044619
Provider Name (Legal Business Name): SPINE CENTER OF ARIZONA, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8466 W PEORIA AVE SUITE 6
PEORIA AZ
85345-6548
US

IV. Provider business mailing address

8466 W PEORIA AVE SUITE 6
PEORIA AZ
85345-6548
US

V. Phone/Fax

Practice location:
  • Phone: 623-845-0664
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number7297
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number28668
License Number StateAZ

VIII. Authorized Official

Name: JAMES H. EVANS III
Title or Position: MANAGING PARTNER
Credential: MD
Phone: 623-845-0664