Provider Demographics
NPI:1255754131
Name:ARIZONA MEDICAL & INJURY PLLC
Entity type:Organization
Organization Name:ARIZONA MEDICAL & INJURY PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BILLING LEAD
Authorized Official - Prefix:MRS
Authorized Official - First Name:DELIA
Authorized Official - Middle Name:F
Authorized Official - Last Name:LEON AGUILAR
Authorized Official - Suffix:
Authorized Official - Credentials:MSPM
Authorized Official - Phone:602-247-8630
Mailing Address - Street 1:ARIZONA MEDICAL & INJURY PLLC DBA STAMP MEDICAL
Mailing Address - Street 2:3655 W ANTHEM WAY SUITE A109#272
Mailing Address - City:ANTHEN
Mailing Address - State:AZ
Mailing Address - Zip Code:85086
Mailing Address - Country:US
Mailing Address - Phone:623-773-2000
Mailing Address - Fax:877-599-5678
Practice Address - Street 1:ARIZONA MEDICAL & INJURY PLLC DBA STAMP MEDICAL
Practice Address - Street 2:3201 W PEORIA AVE SUITE C500-A
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85029-4608
Practice Address - Country:US
Practice Address - Phone:623-773-2000
Practice Address - Fax:877-599-5678
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-28
Last Update Date:2020-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
163WA0400X, 207LP2900X, 208100000X, 261QM1300X, 261QP3300X, 332B00000X, 208VP0014X
AZAP5119363L00000X
AZAP8585363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty
No163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)Group - Multi-Specialty
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-SpecialtyGroup - Multi-Specialty
No261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPainGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Multi-Specialty