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SPINE INNOVATIONS LLC NPI 1366973935


NPI Information

NPI: 1366973935
Provider Name: SPINE INNOVATIONS, LLC
Classification: Specialist - 174400000X
Entity Type: Organization

CLIA Number: 19D2145120

Address:
29301 N DIXIE RANCH RD
LACOMBE, LA
ZIP 70445
Phone: (985) 871-4114
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SPINE INNOVATIONS, LLC is a specialist in Lacombe, LA. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. SPINE INNOVATIONS, LLC NPI is 1366973935. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

29301 N DIXIE RANCH RD
LACOMBE, LA
ZIP 70445-403
Phone: (985) 871-4114
Fax: (985) 871-4130

The provider's authorized official is Donald D Dietze .
The authorized official title is Owner and has the following contact phone number (985) 871-4114.

The CLIA number assigned to this NPI record is 19D2145120 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/24/2017 and was last updated on 3/24/2017.


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:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1174400000XSpecialistMD.19033LOUISIANAYes

Other Identifiers

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

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1F63241MEDICARE UPINLOUISIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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