Healthcare Provider Details

I. General information

NPI: 1245682970
Provider Name (Legal Business Name): ARIZONA PAIN SPECIALISTS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2016
Last Update Date: 07/06/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2696 S COLORADO BLVD SUITE 110
DENVER CO
80222-5945
US

IV. Provider business mailing address

PO BOX 748447
LOS ANGELES CA
90074-8447
US

V. Phone/Fax

Practice location:
  • Phone: 303-277-0962
  • Fax: 303-736-2375
Mailing address:
  • Phone: 480-563-6400
  • Fax: 480-563-8009

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. BRETT KELLER
Title or Position: VP OPERATIONS
Credential:
Phone: 602-694-9401