# NOVASPINE PAIN INSTITUTE, PLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1154745263
- **Authorized official:** DR. CLIFFORD T BAKER M.D. (OWNER)
- **Authorized official phone:** (623) 777-4747

## Contact information

- **Practice address:** 14300 W GRANITE VALLEY DR STE A1, SUN CITY WEST, AZ 85375-5797
- **Practice address phone:** (623) 777-4747
- **Practice address fax:** (623) 777-4748
- **Mailing address:** PO BOX 5068, SUN CITY WEST, AZ 85376-5068
- **Mailing address phone:** (623) 777-4747
- **Mailing address fax:** (623) 777-4748

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | 42990 | AZ | — |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | 42990 | AZ | — |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | 42990 | AZ | — |
| 208VP0000X | Pain Medicine Physician | 42990 | AZ | Yes |
| 208VP0014X | Interventional Pain Medicine Physician | 42990 | AZ | — |
| 332B00000X | Durable Medical Equipment & Medical Supplies | 42990 | AZ | — |

## Other

- **Enumeration date:** 02/10/2014
- **Last updated:** 02/19/2024