Individual
JONATHAN K SONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
13943 N 91ST AVE BLDG E, PEORIA, AZ 85381-3629
(602) 262-8917
(602) 262-8890
Mailing address
645 E MISSOURI AVE STE 300, PHOENIX, AZ 85012-1351
(602) 262-8917
(602) 262-8890
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
009208
AZ
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
009208
AZ
Other
Enumeration date
04/12/2016
Last updated
03/21/2025
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