| Ketamine Infusion Centers | |
|
3724 N 3rd St Ste 201 Phoenix AZ 85012-2034 | |
| (480) 331-4222 | |
| (480) 404-9649 |
| Full Name | Ketamine Infusion Centers |
|---|---|
| Speciality | Clinic/Center |
| Location | 3724 N 3rd St Ste 201, Phoenix, Arizona |
| Authorized Official Name and Position | Sonny Diaz (DIRECTOR) |
| Authorized Official Contact | 6023449850 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ketamine Infusion Centers 3724 N 3rd St Ste 201 Phoenix AZ 85012-2034 Ph: (602) 344-9850 | Ketamine Infusion Centers 3724 N 3rd St Ste 201 Phoenix AZ 85012-2034 Ph: (480) 331-4222 |
| NPI Number | 1740790823 |
|---|---|
| Provider Enumeration Date | 10/03/2017 |
| Last Update Date | 07/30/2021 |
| Medicare PECOS PAC ID | 5698034270 |
|---|---|
| Medicare Enrollment ID | O20180108001049 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740790823 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| 261QI0500X | Clinic/center - Infusion Therapy | (* (Not Available)) | Primary |
| Provider Name | Christopher S Ray |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1548267131 PECOS PAC ID: 1658341326 Enrollment ID: I20040729000654 |
| Provider Name | Dennis R Blaha |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1033175989 PECOS PAC ID: 4082639307 Enrollment ID: I20051005001292 |
| Provider Name | Nicole S Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720550809 PECOS PAC ID: 9335481621 Enrollment ID: I20191007000516 |
Richard A. Snider, Md, Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 12010 S Warner Elliot Loop, Phoenix, AZ 85044 Phone: 480-893-2644 | |
Kelly H. Roy, Md, Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1008 E Mcdowell Rd, Phoenix, AZ 85006 Phone: 602-358-8588 Fax: 602-688-6991 | |
My Family Doctor In The Valley Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 11030 N Tatum Blvd, Ste 101, Phoenix, AZ 85028 Phone: 602-687-8265 | |
Deborah L Dykema Do Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 20045 N 19th Ave Bldg 9-151, Phoenix, AZ 85027 Phone: 602-978-1555 | |
Scottsdale Housecall Physicians, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 11030 N Tatum Blvd Ste 101, Phoenix, AZ 85028 Phone: 602-687-8265 | |
Wings Of Hope Medical Services, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 11022 N 28th Dr Ste 205, Phoenix, AZ 85029 Phone: 602-971-0304 Fax: 602-971-0305 | |
Sheperd Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 9150 W Indian School Rd Ste 111b, Phoenix, AZ 85037 Phone: 623-247-2300 Fax: 623-247-1939 |