Healthcare Provider Details
I. General information
NPI: 1245286814
Provider Name (Legal Business Name): DESERT INSITUTE FOR SPINE DISORDERS, PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/25/2006
Last Update Date: 08/22/2020
Certification Date:
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
- Phone: 480-656-4048
- Fax: 480-247-6146
- Phone: 480-656-4048
- Fax: 480-247-6146
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207XS0117X |
| Taxonomy | Orthopaedic Surgery of the Spine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
DUANE
DH
PITT
Title or Position: PRESIDENT
Credential: M.D.
Phone: 480-656-4048