Healthcare Provider Details

I. General information

NPI: 1194878736
Provider Name (Legal Business Name): DESERT INSTITUTE FOR SPINE DISORDERS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2007
Last Update Date: 10/05/2021
Certification Date: 10/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8573 E PRINCESS DR SUITE 221
SCOTTSDALE AZ
85255-7819
US

IV. Provider business mailing address

8573 E PRINCESS DR SUITE 221
SCOTTSDALE AZ
85255-7819
US

V. Phone/Fax

Practice location:
  • Phone: 480-656-4048
  • Fax: 480-247-6146
Mailing address:
  • Phone: 480-656-4048
  • Fax: 480-247-6146

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number28521
License Number StateAZ

VIII. Authorized Official

Name: DR. DUANE D.H. PITT
Title or Position: PRESIDENT
Credential: MD
Phone: 480-656-4048