Healthcare Provider Details

I. General information

NPI: 1215129994
Provider Name (Legal Business Name): TORY L MCJUNKIN MD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2007
Last Update Date: 07/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9787 N 91ST ST SUITE 101
SCOTTSDALE AZ
85258-5088
US

IV. Provider business mailing address

9787 N 91ST ST SUITE 101
SCOTTSDALE AZ
85258-5088
US

V. Phone/Fax

Practice location:
  • Phone: 480-563-6400
  • Fax: 480-563-8009
Mailing address:
  • Phone: 480-563-6400
  • Fax: 480-563-8009

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number35497
License Number StateAZ

VIII. Authorized Official

Name: DR. TORY LANCE MCJUNKIN
Title or Position: PHYSICIANOWNER
Credential: MD
Phone: 480-563-6400