Healthcare Provider Details

I. General information

NPI: 1811653975
Provider Name (Legal Business Name): SOUTHWEST SPINE AND ORTHOPEDIC CENTER PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/12/2021
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4901 N 44TH ST STE 103
PHOENIX AZ
85018-2782
US

IV. Provider business mailing address

3760 CONVOY ST STE 114
SAN DIEGO CA
92111-3743
US

V. Phone/Fax

Practice location:
  • Phone: 480-719-3355
  • Fax: 858-715-8324
Mailing address:
  • Phone: 858-229-2862
  • Fax: 858-715-8324

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ERIC STEVEN KORSH
Title or Position: MEMBER
Credential: MD
Phone: 480-719-3355