Provider Demographics
NPI:1326222548
Name:NEWSOUTH NEUROSPINE, LLC.
Entity Type:Organization
Organization Name:NEWSOUTH NEUROSPINE, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:S
Authorized Official - Last Name:YORK
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:877-554-4257
Mailing Address - Street 1:2470 FLOWOOD DRIVE
Mailing Address - Street 2:
Mailing Address - City:FLOWOOD
Mailing Address - State:MS
Mailing Address - Zip Code:39232
Mailing Address - Country:US
Mailing Address - Phone:877-554-4257
Mailing Address - Fax:601-983-2845
Practice Address - Street 1:2470 FLOWOOD DRIVE
Practice Address - Street 2:
Practice Address - City:FLOWOOD
Practice Address - State:MS
Practice Address - Zip Code:39232
Practice Address - Country:US
Practice Address - Phone:877-554-4257
Practice Address - Fax:601-983-2845
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-24
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS207LP2900X, 207T00000X, 207XS0117X, 2081N0008X
207T00000X, 261QP2000X, 261QP3300X, 261QR0200X, 261QX0100X
MS08044/11.1332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Multi-Specialty
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty
No207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Multi-Specialty
No2081N0008XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationNeuromuscular MedicineGroup - Multi-Specialty
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain
No261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
No261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS6164110001Medicare NSC