MEDICARE: SOUTHWEST INJURY CENTERS

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	207Q00000X	Family Medicine Physician
2	208VP0014X	Interventional Pain Medicine Physician

General Provider Information

NPI Number	:	1063364974
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTHWEST INJURY CENTERS

Provider Business Mailing Address
First Line	:	702 E BELL RD STE 112
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85022-6639
Country	:	US
Telephone Number	:	602-603-2282
Fax Number	:	602-603-2283

Provider Business Practice Location Address
First Line	:	702 E BELL RD STE 112
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85022-6639
Country	:	US
Telephone Number	:	602-603-2282
Fax Number	:	602-603-2283

Authorized Official
Title or Position	:	CEO
Name	:	DR. PATRICIA S SULLIVAN
Credential	:	MD
Telephone Number	:	602-603-2282

Provider Enumeration Date	:	02/12/2026
Last Update Date	:	02/12/2026

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Practice Location Address:

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Practice Location Address:

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