Healthcare Provider Details

I. General information

NPI: 1659618643
Provider Name (Legal Business Name): ARIZONA SPINE CONSULTANTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2013
Last Update Date: 10/31/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9250 N. 3RD STREET SUITE 2020
PHOENIX AZ
85020
US

IV. Provider business mailing address

9250 N. 3RD STREET SUITE 2020
PHOENIX AZ
85020
US

V. Phone/Fax

Practice location:
  • Phone: 602-242-6500
  • Fax: 602-242-6600
Mailing address:
  • Phone: 602-242-6500
  • Fax: 602-242-6600

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number22703
License Number StateAZ

VIII. Authorized Official

Name: DR. LOUIS H RAPPOPORT
Title or Position: PRESIDENT
Credential: MD
Phone: 602-242-6500