Novaspine Pain Institute, Plc
in Sun City West, AZ. Organization (NPI-2).
NPI number1154745263
StatusActive
Last updated in NPPESFeb 19, 2024
Details
- NPI
- 1154745263
- Entity type
- Organization (NPI-2)
- Legal business name
- Novaspine Pain Institute, Plc
- Organization subpart
- No
- Enumeration date
- Feb 10, 2014
- Certification date
- Feb 19, 2024
- Last updated
- Feb 19, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208VP0000X | 42990 | AZ | Yes | |
| 207L00000X | Anesthesiology | 42990 | AZ | |
| 207LP2900X | Anesthesiology, Pain Medicine | 42990 | AZ | |
| 2081P2900X | Physical Medicine & Rehabilitation, Pain Medicine | 42990 | AZ | |
| 208VP0014X | Pain Medicine, Interventional Pain Medicine | 42990 | AZ | |
| 332B00000X | Durable Medical Equipment & Medical Supplies | 42990 | AZ |
Practice location
14300 W Granite Valley Dr Ste A1Sun City West, AZ 85375-5797
Phone 623-777-4747 · Fax 623-777-4748
Mailing address
Po Box 5068Sun City West, AZ 85376-5068
Phone 623-777-4747 · Fax 623-777-4748
Other practice locations
13203 N 103rd Ave Ste H5
Sun City, AZ 85351-3032
Sun City, AZ 85351-3032
Phone 623-777-4747
17100 N 67th Ave Ste 300
Glendale, AZ 85308-3657
Glendale, AZ 85308-3657
Phone 623-777-4747
Authorized official
Clifford T Baker
Owner
6237774747
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