Provider Demographics
NPI:1134681125
Name:NEURO SPINE INSTITUTE PLLC
Entity Type:Organization
Organization Name:NEURO SPINE INSTITUTE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:HARRY
Authorized Official - Last Name:OPPENHEIMER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:503-706-8272
Mailing Address - Street 1:3107 W HALLANDALE BEACH BLVD STE 1
Mailing Address - Street 2:
Mailing Address - City:HALLANDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33009-5144
Mailing Address - Country:US
Mailing Address - Phone:954-458-4488
Mailing Address - Fax:954-458-2928
Practice Address - Street 1:29255 NORTHWESTERN HWY STE 202
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48034-5741
Practice Address - Country:US
Practice Address - Phone:248-556-3727
Practice Address - Fax:248-556-3813
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-01
Last Update Date:2019-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty