Provider Demographics
NPI:1073865572
Name:WHITE MOUNTAIN PAIN ASSOCIATES PC
Entity Type:Organization
Organization Name:WHITE MOUNTAIN PAIN ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:J
Authorized Official - Last Name:BROWNSBERGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-361-7680
Mailing Address - Street 1:PO BOX 72090
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85050-1019
Mailing Address - Country:US
Mailing Address - Phone:480-361-7680
Mailing Address - Fax:480-361-7683
Practice Address - Street 1:2451 S WHITE MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:SHOW LOW
Practice Address - State:AZ
Practice Address - Zip Code:85901-7306
Practice Address - Country:US
Practice Address - Phone:928-532-7559
Practice Address - Fax:928-532-8599
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-08
Last Update Date:2012-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty