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NPI Code Detail

MEDICARE: ARIZONA PAIN SPECIALISTS PLLC

MEDICARE: ARIZONA PAIN SPECIALISTS 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
1208VP0000XPain Medicine Physician35497AZ

General Provider Information

NPI Number : 1588117063
Entity Type Code : Organization
Provider Name (Legal Business Name) : ARIZONA PAIN SPECIALISTS PLLC
Provider Business Mailing Address
First Line : 9787 N 91ST ST
Second Line :
City : SCOTTSDALE
State : AZ
Zip : 85258-5088
Country : US
Telephone Number : 480-563-6400
Fax Number : 480-563-8009
Provider Business Practice Location Address
First Line : 705 N LEROUX ST
Second Line :
City : FLAGSTAFF
State : AZ
Zip : 86001-3225
Country : US
Telephone Number : 480-563-6400
Fax Number : 480-563-8009
Authorized Official
Title or Position : VP OPERATIONS
Name : MR. BRET KELLER
Credential :
Telephone Number : 460-563-6400
Provider Enumeration Date : 08/01/2016
Last Update Date : 08/01/2016

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Directions to “ARIZONA PAIN SPECIALISTS PLLC ” Practice Location

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