Organization
HERRO ANESTHESIA & PAIN LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELLISON F HERRO MD (MANAGING MEMBER)
(602) 264-1395
Entity
Organization
Contact information
Practice address
5115 N CENTRAL AVE, PHOENIX, AZ 85012-1478
(602) 264-1818
(602) 264-8015
Mailing address
5133 N CENTRAL AVE, STE 200, PHOENIX, AZ 85012-1438
(602) 264-1395
(602) 264-2172
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
8949
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
213257
—
AZ
01
—
AZ0057000
BLUE CROSS BLUE SHIELD AZ
AZ
Enumeration date
08/21/2006
Last updated
04/11/2018
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