Provider Demographics
NPI:1073133054
Name:JOSEPH LARATTA MD SPINE SURGEON, LLC
Entity Type:Organization
Organization Name:JOSEPH LARATTA MD SPINE SURGEON, LLC
Other - Org Name:THE NECK AND BACK INSTITUTE OF KENTUCKY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:L
Authorized Official - Last Name:LARATTA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-979-1370
Mailing Address - Street 1:743 E BROADWAY # 171
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-1711
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1169 EASTERN PKWY STE 400
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40217-1412
Practice Address - Country:US
Practice Address - Phone:502-413-5777
Practice Address - Fax:502-413-5766
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-20
Last Update Date:2021-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Single Specialty