Organization
NOVASPINE PAIN INSTITUTE, PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CLIFFORD T BAKER M.D. (OWNER/PHYSICIAN)
(602) 538-1180
Entity
Organization
Contact information
Practice address
13203 N 103RD AVE, SUITE H5, SUN CITY, AZ 85351-3028
(623) 777-4747
(623) 777-4748
Mailing address
13203 N 103RD AVE, SUITE H5, SUN CITY, AZ 85351-3028
(623) 777-4747
(623) 777-4748
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
42290
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
42990
AZ LICENSE
AZ
Enumeration date
10/19/2016
Last updated
04/28/2021
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