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Organization
CANYON PAIN AND SPINE
Active
Organization
CANYON PAIN AND SPINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIRK BOWDEN (OWNER)
(937) 206-0377
Entity
Organization
Contact information
Practice address
10238 E HAMPTON AVE STE 416, MESA, AZ 85209-3320
(480) 561-5000
Mailing address
4156 E SIERRA MADRE AVE, GILBERT, AZ 85296-3084
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
NULL
207L00000X
Anesthesiology Physician
—
—
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
NULL
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
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
04/12/2021
Last updated
12/30/2022
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