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General NPI Number Information
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NPI Number | 1356151237
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Entity Type | Organization
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Legal Business Name | SOUTHWEST SPINE & BACK PLLC
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Dates
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Enumeration Date | 01/13/2025
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Last Update Date | 11/20/2025
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Provider Practice Location Address
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Address Line | 15571 N REEMS RD BLDG D
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City | SURPRISE
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State | AZ
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Zip | 85374-9584
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Country | US
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Telephone | 623-887-9454
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Fax | 623-887-9451
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Provider Business Mailing Address
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Address Line | 15571 N REEMS RD BLDG D
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City | SURPRISE
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State | AZ
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Zip | 85374-9584
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Country | US
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Telephone | 623-887-9454
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Fax | 623-887-9451
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Authorized Official
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Title or Position | MANAGER
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Name | SMITH SHARMA
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Credential |
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Telephone | 480-478-5557
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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