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Organization

DESERT PAIN AND REHAB SPECIALISTS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. HERBERT DONALD GOODMAN M.D. (CO-OWNER)
(602) 944-2222
Entity
Organization

Contact information

Practice address
11047 N 19TH AVE, PHOENIX, AZ 85029
(602) 944-2222
(602) 331-2499
Mailing address
11047 N 19TH AVE, PHOENIX, AZ 85029-4816
(602) 944-2222
(602) 331-2499

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
3984
AZ
207RA0401X
Addiction Medicine (Internal Medicine) Physician
11336
AZ
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
208VP0014X
Interventional Pain Medicine Physician

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
306932
AZ
Enumeration date
12/27/2006
Last updated
06/24/2019
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