Provider Demographics
NPI:1225487044
Name:PINNACLE PAIN & SPINE CONSULTANTS, PLC
Entity Type:Organization
Organization Name:PINNACLE PAIN & SPINE CONSULTANTS, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:T
Authorized Official - Last Name:CROOKS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-407-6400
Mailing Address - Street 1:PO BOX 15638
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85267-5638
Mailing Address - Country:US
Mailing Address - Phone:480-407-6400
Mailing Address - Fax:480-407-6520
Practice Address - Street 1:9023 E DESERT COVE AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-6714
Practice Address - Country:US
Practice Address - Phone:480-407-6400
Practice Address - Fax:480-407-6520
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-13
Last Update Date:2019-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ42847207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ192033Medicare PIN