Healthcare Provider Details

I. General information

NPI: 1619478732
Provider Name (Legal Business Name): ROBERT J. BROWNSBERGER, MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2018
Last Update Date: 02/23/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2451 S WHITE MOUNTAIN RD
SHOW LOW AZ
85901-7306
US

IV. Provider business mailing address

PO BOX 14665
SCOTTSDALE AZ
85267-4665
US

V. Phone/Fax

Practice location:
  • Phone: 928-532-7599
  • Fax: 928-532-8599
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number23429
License Number StateAZ

VIII. Authorized Official

Name: DR. ROBERT JOSEPH BROWNSBERGER
Title or Position: MEDICAL DOCTOR
Credential: MD
Phone: 928-774-3919