Organization
SUNRISE ANESTHESIA & PAIN MANAGEMENT, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN CLIFFORD ALLEN CRNA,MS (EXECUTIVE DIRECTOR)
(928) 468-3132
Entity
Organization
Contact information
Practice address
114 S MOUNTAIN AVE, WHITE MOUNTAIN SPECIALTY CLINIC, SPRINGERVILLE, AZ 85938-5104
(928) 468-3132
(888) 717-3257
Mailing address
PO BOX 1917, SUNRISE ANESTHESIA & PAIN MANAGEMENT, PLLC, SPRINGERVILLE, AZ 85938-1917
(928) 468-3132
(888) 717-3257
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
FELLOW,CPP #8633
AZ
208VP0014X
Interventional Pain Medicine Physician
FELLOW, CPP #8633
AZ
367500000X
Certified Registered Nurse Anesthetist
CRNA0632
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
464411
AHCCCS
AZ
Enumeration date
06/11/2009
Last updated
09/13/2011
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