Organization
CERVICAL SPINE CENTERS, PLLC
Active
Other names
Cervical Spine Centers
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN R EHTESHAMI MD (CEO)
(480) 656-4220
Entity
Organization
Contact information
Practice address
20280 N 59TH AVE STE 115-345, GLENDALE, AZ 85308-6850
(480) 656-4220
(480) 656-1554
Mailing address
20280 N 59TH AVE STE 115-345, GLENDALE, AZ 85308-6850
(480) 656-4220
(480) 656-1554
Taxonomy
Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
41787
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
022926
—
AZ
01
—
41787
AZ MD LICENSE
AZ
Enumeration date
05/18/2015
Last updated
01/07/2025
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