Organization
PAIN CENTERS OF AMERICA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARY GEORGE THEOFILIS DO (PRESIDENT)
(412) 477-4493
Entity
Organization
Contact information
Practice address
9100 EAST RAINTREE DRIVE, SUITE 248, SCOTTSDALE, AZ 85260
(412) 477-4493
Mailing address
9100 E RAINTREE DR, SUITE 248, SCOTTSDALE, AZ 85260-2762
(412) 477-4493
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
006356
AZ
207LP2900X
Pain Medicine (Anesthesiology) Physician
OS015718
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
915900
—
AZ
Enumeration date
12/16/2014
Last updated
12/16/2014
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