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PHOENIX PAIN TREATMENT CENTER NPI 1164690160


NPI Information

NPI: 1164690160
Provider Name: PHOENIX PAIN TREATMENT CENTER

Other Name: INTEGRATED ADDICTION MEDICINE

Classification: Counselor - 101YA0400X
Entity Type: Organization

Specialization: Addiction (Substance Use Disorder)

Address:
3124 E ROOSEVELT ST # D-2
PHOENIX, AZ
ZIP 85008
Phone: (602) 244-9200
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PHOENIX PAIN TREATMENT CENTER is an addiction (substance use disorder) counselor in Phoenix, AZ. PHOENIX PAIN TREATMENT CENTER NPI is 1164690160. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Other Name Is Integrated Addiction Medicine.

The provider's business location address is:

3124 E ROOSEVELT ST # D-2
PHOENIX, AZ
ZIP 85008-088
Phone: (602) 244-9200
Fax: (602) 244-9222

The provider's authorized official is William Murray Smith .
The authorized official title is Medical Director and has the following contact phone number (602) 244-9200.

The enumeration date for this NPI number is 2/13/2008 and was last updated on 2/13/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1101YA0400XCounselorAddiction (Substance Use Disorder)LISAC-10277ARIZONAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1105694MEDICARE OSCAR/CERTIFICATIONARIZONA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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