INDIANA SPINE AND PAIN CENTER INC NPI 1265644397

NPI Information

INDIANA SPINE AND PAIN CENTER INC is a medical specialty clinic center in Indianapolis, IN. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). INDIANA SPINE AND PAIN CENTER INC NPI is 1265644397. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Indiana Laser Spine Center Inc.

The provider's business location address is:

8202 CLEARVISTA PARKWAY
SUITE 9 E
INDIANAPOLIS, IN
ZIP 46256-457
Phone: (317) 577-1800
Fax: (317) 577-1805

The provider's authorized official is Phillip R. Kingma .
The authorized official title is Owner/physician and has the following contact phone number (317) 577-1800.

The enumeration date for this NPI number is 5/3/2007 and was last updated on 2/8/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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