Healthcare Provider Details

I. General information

NPI: 1255906665
Provider Name (Legal Business Name): URGENTLY ORTHO PAIN MANAGEMENT AND WELLNESS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2021
Last Update Date: 09/09/2021
Certification Date: 09/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13402 N SCOTTSDALE RD STE A125
SCOTTSDALE AZ
85254-4055
US

IV. Provider business mailing address

13402 N SCOTTSDALE RD STE A125
SCOTTSDALE AZ
85254-4055
US

V. Phone/Fax

Practice location:
  • Phone: 480-530-7575
  • Fax: 602-429-8336
Mailing address:
  • Phone: 480-530-7575
  • Fax: 602-429-8336

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. ANN CHERI FOXX LEACH
Title or Position: CO-OWNER
Credential: MD
Phone: 480-530-7575