Healthcare Provider Details

I. General information

NPI: 1225690076
Provider Name (Legal Business Name): CENTER FOR PAIN MANAGEMENT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2019
Last Update Date: 10/28/2020
Certification Date: 10/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6060 N FOUNTAIN DRIVE
TUCSON AZ
85741
US

IV. Provider business mailing address

PO BOX 841205
DALLAS TX
75284-1205
US

V. Phone/Fax

Practice location:
  • Phone: 520-877-4254
  • Fax: 877-319-4035
Mailing address:
  • Phone: 520-877-4254
  • Fax: 877-319-4035

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JAMES PATRICK WRIGHT
Title or Position: VP PHYSICIAN BUSINESS SERVICES
Credential:
Phone: 615-465-7587