Provider Demographics
NPI:1609973981
Name:SPINE SPECIALISTS OF ARIZONA PC
Entity Type:Organization
Organization Name:SPINE SPECIALISTS OF ARIZONA PC
Other - Org Name:SPINE SPECIALISTS OF ARIZONA PC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:MR
Authorized Official - First Name:ALI
Authorized Official - Middle Name:
Authorized Official - Last Name:ARAGHI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:602-393-2225
Mailing Address - Street 1:1820 W MARYLAND AVE
Mailing Address - Street 2:1&2
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85015-1740
Mailing Address - Country:US
Mailing Address - Phone:602-393-2225
Mailing Address - Fax:602-393-2227
Practice Address - Street 1:1820 W MARYLAND AVE
Practice Address - Street 2:1&2
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85015-1740
Practice Address - Country:US
Practice Address - Phone:602-393-2225
Practice Address - Fax:602-393-2227
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2009-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ5878540001Medicare NSC