MEDICARE: ARIZONA SPINE AND JOINT HOSPITAL 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	282N00000X	General Acute Care Hospital	SH3711	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1396745832
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARIZONA SPINE AND JOINT HOSPITAL LLC

Provider Business Mailing Address
First Line	:	4620 E. BASELINE ROAD
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85206
Country	:	US
Telephone Number	:	480-824-1226
Fax Number	:	480-824-1269

Provider Business Practice Location Address
First Line	:	4620 E. BASELINE ROAD
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85206
Country	:	US
Telephone Number	:	480-824-1226
Fax Number	:	480-824-1269

Authorized Official
Title or Position	:	OFFICER/AUTHORIZED OFFICIAL
Name	:	MR. ERIC BOON
Credential	:
Telephone Number	:	480-567-0269

Provider Enumeration Date	:	07/27/2005
Last Update Date	:	07/30/2025

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Directions to “ARIZONA SPINE AND JOINT HOSPITAL LLC ” Practice Location

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