MEDICARE: BRIAN S PAGE DO LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1063221299
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRIAN S PAGE DO LLC

Provider Business Mailing Address
First Line	:	20325 N 51ST AVE STE 160
Second Line	:
City	:	GLENDALE
State	:	AZ
Zip	:	85308-4622
Country	:	US
Telephone Number	:	623-466-6350
Fax Number	:	602-358-8698

Provider Business Practice Location Address
First Line	:	9620 N METRO PKWY W STE 143
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85051-1441
Country	:	US
Telephone Number	:	623-466-6350
Fax Number	:

Authorized Official
Title or Position	:	CFO
Name	:	MICHAEL VON KOLEN
Credential	:
Telephone Number	:	800-285-3755

Provider Enumeration Date	:	01/02/2025
Last Update Date	:	06/12/2026

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Directions to “BRIAN S PAGE DO LLC ” Practice Location

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