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General NPI Number Information
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NPI Number | 1811037146
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Entity Type | Organization
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Legal Business Name | ARIZONA PAIN CONSULTANT PC
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Dates
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Enumeration Date | 02/07/2007
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Last Update Date | 01/25/2008
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Provider Practice Location Address
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Address Line | 13555 W MCDOWELL RD SUITE 203
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City | GOODYEAR
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State | AZ
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Zip | 85338-2624
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Country | US
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Telephone | 832-419-9249
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 29211
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City | PHOENIX
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State | AZ
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Zip | 85038-9211
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Country | US
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Telephone | 602-273-6770
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Fax | 602-889-0489
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Authorized Official
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Title or Position | OWNER
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Name | GBADEBO ADEBAYO
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Credential | M.D.
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Telephone | 602-273-6770
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 35778
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License Number State | AZ
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