Provider Demographics
NPI:1699118943
Name:ORMOND, SEAN MICHAEL (MD)
Entity type:Individual
Prefix:
First Name:SEAN
Middle Name:MICHAEL
Last Name:ORMOND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18205 N 51ST AVE STE 125
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-1491
Mailing Address - Country:US
Mailing Address - Phone:602-492-9821
Mailing Address - Fax:602-492-9822
Practice Address - Street 1:18205 N 51ST AVE STE 125
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-1491
Practice Address - Country:US
Practice Address - Phone:602-492-9821
Practice Address - Fax:602-492-9822
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-16
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ56159207LP2900X, 208VP0000X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine