Healthcare Provider Details

I. General information

NPI: 1063804979
Provider Name (Legal Business Name): AZ PAIN AND INJURY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/02/2015
Last Update Date: 03/02/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5062 N 19TH AVE SUITE 100
PHOENIX AZ
85015-3225
US

IV. Provider business mailing address

5062 N 19TH AVE SUITE 100
PHOENIX AZ
85015-3225
US

V. Phone/Fax

Practice location:
  • Phone: 602-395-0718
  • Fax: 602-343-7973
Mailing address:
  • Phone: 602-395-0718
  • Fax: 602-343-7973

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DR. SCOTT STAMP
Title or Position: OWNER
Credential: DC
Phone: 602-308-7829