Provider Demographics
NPI:1952470536
Name:ARIZONA SPINE CARE PLC
Entity Type:Organization
Organization Name:ARIZONA SPINE CARE PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:HAWKINS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-956-0044
Mailing Address - Street 1:9305 W THOMAS RD
Mailing Address - Street 2:SUITE 555
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85037-3328
Mailing Address - Country:US
Mailing Address - Phone:602-956-0044
Mailing Address - Fax:602-956-3377
Practice Address - Street 1:9305 W THOMAS RD
Practice Address - Street 2:SUITE 555
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85037-3328
Practice Address - Country:US
Practice Address - Phone:602-956-0044
Practice Address - Fax:602-956-3377
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
Last Update Date:2015-01-06
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
AZ104990Medicare PIN
AZ6194790001Medicare NSC