Organization
SPINE CIN OF PHOENIX LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD LELAND HUTTON EADIE (DIRECTOR)
(615) 733-2064
Entity
Organization
Contact information
Practice address
2155 W PINNACLE PEAK RD STE 201A, PHOENIX, AZ 85027-1201
(615) 386-0064
(615) 386-0067
Mailing address
102 WOODMONT BLVD STE 350, NASHVILLE, TN 37205-2216
(615) 386-0064
(615) 386-0067
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
AZ
207XS0117X
Orthopaedic Surgery of the Spine Physician
—
AZ
Other
Enumeration date
01/31/2018
Last updated
01/31/2018
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