Healthcare Provider Details

I. General information

NPI: 1275048316
Provider Name (Legal Business Name): VALLEY OF THE SUN INSTITUTE FOR PAIN MANAGEMENT, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2017
Last Update Date: 08/18/2022
Certification Date: 08/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4921 E BELL RD STE 203
SCOTTSDALE AZ
85254-6002
US

IV. Provider business mailing address

13835 N TATUM BLVD STE 9326
PHOENIX AZ
85032-0409
US

V. Phone/Fax

Practice location:
  • Phone: 480-955-1515
  • Fax: 844-287-5554
Mailing address:
  • Phone: 480-955-1515
  • Fax: 844-287-5554

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP3300X
TaxonomyPain Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ESTELLE R FARRELL
Title or Position: OWNER/PHYSICIAN
Credential: DO
Phone: 480-955-1515