Provider Demographics
NPI:1427595073
Name:AMERICAN INJURY NETWORK
Entity Type:Organization
Organization Name:AMERICAN INJURY NETWORK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARC
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:WIDOFF
Authorized Official - Suffix:
Authorized Official - Credentials:DC MD
Authorized Official - Phone:480-688-1894
Mailing Address - Street 1:7904 E CHAPARRAL RD
Mailing Address - Street 2:SUITE A110
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85250-7210
Mailing Address - Country:US
Mailing Address - Phone:480-688-1894
Mailing Address - Fax:480-905-7750
Practice Address - Street 1:7904 E CHAPARRAL RD
Practice Address - Street 2:SUITE A110
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85250-7210
Practice Address - Country:US
Practice Address - Phone:480-688-1894
Practice Address - Fax:480-905-7750
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-20
Last Update Date:2017-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Multi-Specialty