Provider Demographics
NPI:1083479455
Name:ARIZONA PAIN TREATMENT CENTER P C
Entity Type:Organization
Organization Name:ARIZONA PAIN TREATMENT CENTER P C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:ADKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-265-8800
Mailing Address - Street 1:8805 N 23RD AVE STE 120
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85021-4149
Mailing Address - Country:US
Mailing Address - Phone:602-254-6879
Mailing Address - Fax:
Practice Address - Street 1:4860 E BASELINE RD STE 103
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-4670
Practice Address - Country:US
Practice Address - Phone:602-254-6879
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-15
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty