Provider Demographics
NPI:1578179735
Name:AZ NEUROSURGERY & SPINE, PLLC
Entity type:Organization
Organization Name:AZ NEUROSURGERY & SPINE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:R
Authorized Official - Last Name:SPITALIERI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:928-447-7463
Mailing Address - Street 1:371 GARDEN ST # A-27
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86305-2914
Mailing Address - Country:US
Mailing Address - Phone:928-447-7463
Mailing Address - Fax:928-441-1777
Practice Address - Street 1:999 DIVISION ST
Practice Address - Street 2:
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86301-1654
Practice Address - Country:US
Practice Address - Phone:928-447-7463
Practice Address - Fax:928-441-1777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-22
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty