Healthcare Provider Details

I. General information

NPI: 1982335493
Provider Name (Legal Business Name): ARIZONA PAIN SPECIALISTS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2022
Last Update Date: 06/23/2022
Certification Date: 06/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2340 E BEARDSLEY RD STE 110
PHOENIX AZ
85024-1286
US

IV. Provider business mailing address

PO BOX 6408
SCOTTSDALE AZ
85261-6408
US

V. Phone/Fax

Practice location:
  • Phone: 480-563-6400
  • Fax: 480-563-8009
Mailing address:
  • Phone: 148-024-5600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: PAUL LYNCH
Title or Position: CEO
Credential: MD
Phone: 480-563-6400