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General NPI Number Information
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NPI Number | 1477098432
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Entity Type | Organization
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Legal Business Name | PHOENIX SPINE SURGEONS, LTD
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Dates
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Enumeration Date | 12/30/2016
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Last Update Date | 12/17/2023
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Provider Practice Location Address
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Address Line | 140 N LITCHFIELD RD SUITE 110
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City | GOODYEAR
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State | AZ
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Zip | 85338
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Country | US
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Telephone | 602-256-2525
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Fax | 602-256-0795
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Provider Business Mailing Address
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Address Line | 2525 E ARIZONA BILTMORE CIR SUITE D-142
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City | PHOENIX
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State | AZ
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Zip | 85016-2146
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Country | US
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Telephone | 602-256-2525
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Fax | 602-256-0795
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Authorized Official
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Title or Position | OPERATIONS DIRECTOR
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Name | HANNAH LIEBERMAN
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Credential |
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Telephone | 602-256-2525
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number | 22004
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number | 28519
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License Number State | AZ
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