Provider Demographics
NPI:1518381037
Name:CONCIERGE PAIN MANAGEMENT, LLC
Entity Type:Organization
Organization Name:CONCIERGE PAIN MANAGEMENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:CLAY
Authorized Official - Last Name:BIGHAM
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:480-419-1189
Mailing Address - Street 1:10025 E DYNAMITE BLVD
Mailing Address - Street 2:B145
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85262-3688
Mailing Address - Country:US
Mailing Address - Phone:480-419-1189
Mailing Address - Fax:
Practice Address - Street 1:10025 E DYNAMITE BLVD
Practice Address - Street 2:B130
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85262-3688
Practice Address - Country:US
Practice Address - Phone:480-419-1189
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-05
Last Update Date:2017-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty