Healthcare Provider Details

I. General information

NPI: 1972998979
Provider Name (Legal Business Name): ACCUSPINE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2015
Last Update Date: 04/06/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9377 E BELL RD STE 201
SCOTTSDALE AZ
85260-1503
US

IV. Provider business mailing address

PO BOX 674074
DALLAS TX
75267-4074
US

V. Phone/Fax

Practice location:
  • Phone: 214-396-3936
  • Fax: 888-624-8659
Mailing address:
  • Phone: 214-396-3936
  • Fax: 888-624-8659

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number42278
License Number StateAZ

VIII. Authorized Official

Name: MISS BRANDY BARROW
Title or Position: CREDITIAL COORDINATOR
Credential:
Phone: 214-396-3936