# ARIZONA MEDICAL SPINE INSTITUTE

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Arizona Back Institute
- **Organization subpart:** No

## Provider details

- **NPI number:** 1700910270
- **Authorized official:** DR. RANDALL PRUITT (PRESIDENT)
- **Authorized official phone:** (480) 503-3344

## Contact information

- **Practice address:** 4530 E RAY RD, SUITE 150, PHOENIX, AZ 85044-6094
- **Practice address phone:** (480) 503-3344
- **Practice address fax:** (480) 763-0417
- **Mailing address:** 4530 E RAY RD, SUITE 150, PHOENIX, AZ 85044-6094
- **Mailing address phone:** (480) 503-3344
- **Mailing address fax:** (480) 763-0417

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | 20012 | AZ | Yes |

## Other

- **Enumeration date:** 03/15/2007
- **Last updated:** 08/22/2020