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NPI Code Detail

MEDICARE: PC PAIN DOCTORS, PLLC

MEDICARE: PC PAIN DOCTORS, PLLC
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
1261QM2500XMedical Specialty Clinic/Center
2261QP3300XPain Clinic/Center2951AZ

General Provider Information

NPI Number : 1124271861
Entity Type Code : Organization
Provider Name (Legal Business Name) : PC PAIN DOCTORS, PLLC
Provider Business Mailing Address
First Line : 1821 N TREKELL RD STE A3
Second Line :
City : CASA GRANDE
State : AZ
Zip : 85122-1705
Country : US
Telephone Number : 520-421-0986
Fax Number : 520-421-2009
Provider Business Practice Location Address
First Line : 1821 N TREKELL RD STE A3
Second Line :
City : CASA GRANDE
State : AZ
Zip : 85122-1705
Country : US
Telephone Number : 520-421-0986
Fax Number : 520-421-2009
Authorized Official
Title or Position : BUSINESS MANAGER
Name : JESSICA HANEY
Credential :
Telephone Number : 520-421-0986
Provider Enumeration Date : 10/28/2008
Last Update Date : 01/17/2020

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Directions to “PC PAIN DOCTORS, PLLC ” Practice Location

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