Provider Demographics
NPI:1245450857
Name:PHOENIX MEDICAL SERVICES PC
Entity type:Organization
Organization Name:PHOENIX MEDICAL SERVICES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:BROWNING
Authorized Official - Last Name:JONES
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:516-766-0393
Mailing Address - Street 1:165 N VILLAGE AVE
Mailing Address - Street 2:SUITE 5
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11570-3761
Mailing Address - Country:US
Mailing Address - Phone:516-766-0393
Mailing Address - Fax:516-766-2405
Practice Address - Street 1:165 N VILLAGE AVE
Practice Address - Street 2:SUITE 5
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570-3761
Practice Address - Country:US
Practice Address - Phone:516-766-0393
Practice Address - Fax:516-766-2405
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-26
Last Update Date:2009-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY209039208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty