Healthcare Provider Details

I. General information

NPI: 1154545796
Provider Name (Legal Business Name): VIVEK IYER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/13/2007
Last Update Date: 11/19/2025
Certification Date: 11/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23015 N SCOTTSDALE RD STE 101
SCOTTSDALE AZ
85255-4493
US

IV. Provider business mailing address

23015 N SCOTTSDALE RD STE 101
SCOTTSDALE AZ
85255-4493
US

V. Phone/Fax

Practice location:
  • Phone: 480-222-7246
  • Fax:
Mailing address:
  • Phone: 480-222-7246
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number49740
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: