MEDICARE: DESERT PAIN SPECIALISTS, 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	207LP2900X	Pain Medicine (Anesthesiology) Physician	5758849-1205	UT

General Provider Information

NPI Number	:	1871762450
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DESERT PAIN SPECIALISTS, LLC

Provider Business Mailing Address
First Line	:	634 CYNTHIA LN
Second Line	:
City	:	SANTA CLARA
State	:	UT
Zip	:	84765-5634
Country	:	US
Telephone Number	:	435-216-7000
Fax Number	:

Provider Business Practice Location Address
First Line	:	617 E RIVERSIDE DR STE 301
Second Line	:
City	:	SAINT GEORGE
State	:	UT
Zip	:	84790-8722
Country	:	US
Telephone Number	:	435-216-7000
Fax Number	:	435-216-7001

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JOSEPH COURT EMPEY
Credential	:	MD
Telephone Number	:	435-216-7000

Provider Enumeration Date	:	02/27/2008
Last Update Date	:	01/23/2019

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