Healthcare Provider Details

I. General information

NPI: 1649411778
Provider Name (Legal Business Name): DESERT SPINE AND SPORTS PHYSICIANS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2009
Last Update Date: 07/15/2025
Certification Date: 07/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3700 N 24TH ST STE 210
PHOENIX AZ
85016-6536
US

IV. Provider business mailing address

3700 N 24TH ST STE 210
PHOENIX AZ
85016-6536
US

V. Phone/Fax

Practice location:
  • Phone: 602-840-0681
  • Fax: 602-957-1570
Mailing address:
  • Phone: 602-840-0681
  • Fax: 602-957-1570

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number33710
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number33710
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License Number33710
License Number StateAZ

VIII. Authorized Official

Name: DR. BRAD STEVEN SOROSKY
Title or Position: OWNER/PHYSICIAN
Credential: MD
Phone: 602-840-0681