Healthcare Provider Details

I. General information

NPI: 1396034625
Provider Name (Legal Business Name): ARIZONA PAIN CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/07/2011
Last Update Date: 04/07/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8787 E MOUNTAIN VIEW RD UNIT 1025
SCOTTSDALE AZ
85258-1452
US

IV. Provider business mailing address

8787 E MOUNTAIN VIEW RD UNIT 1025
SCOTTSDALE AZ
85258-1452
US

V. Phone/Fax

Practice location:
  • Phone: 602-677-8981
  • Fax: 888-461-9729
Mailing address:
  • Phone: 602-677-8981
  • Fax: 888-461-9729

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. DAVID GREENE
Title or Position: OWNER
Credential: MD
Phone: 602-677-8981