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Organization
SOUTHWEST PRIME CONSULTING SERVICES
Active
Organization
SOUTHWEST PRIME CONSULTING SERVICES
Active
Other names
Southwest Prime Consulting Services, Premier Health Network
Organization subpart
No
Provider details
NPI number
Authorized official
JUSTIN TYLER (CHIEF EXECUTIVE OFFICER)
(480) 388-7585
Entity
Organization
Contact information
Practice address
1747 E GARNET AVE, MESA, AZ 85204-6013
(480) 388-7585
Mailing address
1747 E GARNET AVE, MESA, AZ 85204-6013
(480) 388-7585
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
—
NULL
208VP0000X
Pain Medicine Physician
Primary
—
—
208VP0014X
Interventional Pain Medicine Physician
—
NULL
208VP0014X
Interventional Pain Medicine Physician
—
—
Other
Enumeration date
04/29/2024
Last updated
08/21/2025
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