Organization
ARIZONA SPINE AND PAIN SPECIALISTS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICK W HOGAN DO (MEMBER/MANAGING EMPLOYEE)
(602) 795-8700
Entity
Organization
Contact information
Practice address
1760 E FLORENCE BLVD STE 140, CASA GRANDE, AZ 85122-4765
(602) 795-8700
(602) 795-8701
Mailing address
20280 N 59TH AVE, STE 115-617, GLENDALE, AZ 85308-6850
(602) 795-8700
(602) 795-8701
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
947192
—
AZ
01
—
Z172895
MEDICARE PTAN
AZ
Enumeration date
03/01/2016
Last updated
11/05/2018
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