Provider Demographics
NPI:1790221323
Name:SOUTHWEST PAIN CONSULTANTS PLLC
Entity Type:Organization
Organization Name:SOUTHWEST PAIN CONSULTANTS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TOURE
Authorized Official - Middle Name:ALI
Authorized Official - Last Name:KNIGHTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-710-1017
Mailing Address - Street 1:2303 N 44TH ST
Mailing Address - Street 2:STE. 14-1472
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85008-2442
Mailing Address - Country:US
Mailing Address - Phone:602-710-1017
Mailing Address - Fax:
Practice Address - Street 1:2303 N 44TH ST
Practice Address - Street 2:STE. 14-1472
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85008-2442
Practice Address - Country:US
Practice Address - Phone:602-710-1017
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-06
Last Update Date:2017-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty