Provider Demographics
NPI:1558044263
Name:INNOVATIVE PAIN AND WELLNESS PLC
Entity Type:Organization
Organization Name:INNOVATIVE PAIN AND WELLNESS PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER MD
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:KARL
Authorized Official - Last Name:OCONNOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-306-7242
Mailing Address - Street 1:18511 N SCOTTSDALE RD STE 202
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-9694
Mailing Address - Country:US
Mailing Address - Phone:480-306-7242
Mailing Address - Fax:480-306-6246
Practice Address - Street 1:6553 E BAYWOOD AVE STE 201
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-1754
Practice Address - Country:US
Practice Address - Phone:480-206-7242
Practice Address - Fax:480-306-6246
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-09
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontologyGroup - Multi-Specialty