Healthcare Provider Details

I. General information

NPI: 1609973981
Provider Name (Legal Business Name): SPINE SPECIALISTS OF ARIZONA PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 04/08/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1820 W MARYLAND AVE 1&2
PHOENIX AZ
85015-1740
US

IV. Provider business mailing address

1820 W MARYLAND AVE 1&2
PHOENIX AZ
85015-1740
US

V. Phone/Fax

Practice location:
  • Phone: 602-393-2225
  • Fax: 602-393-2227
Mailing address:
  • Phone: 602-393-2225
  • Fax: 602-393-2227

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number
License Number StateAZ

VIII. Authorized Official

Name: MR. ALI ARAGHI
Title or Position: PHYSICIAN
Credential: D.O.
Phone: 602-393-2225