Provider Demographics
NPI:1386042844
Name:PAIN AND SPINE AT ST. FRANCIS
Entity Type:Organization
Organization Name:PAIN AND SPINE AT ST. FRANCIS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:LIPPERT
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:719-380-7246
Mailing Address - Street 1:6011 E WOODMEN RD
Mailing Address - Street 2:SUITE 365
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80923-2602
Mailing Address - Country:US
Mailing Address - Phone:719-380-7246
Mailing Address - Fax:719-380-8282
Practice Address - Street 1:6011 E WOODMEN RD
Practice Address - Street 2:SUITE 365
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80923-2602
Practice Address - Country:US
Practice Address - Phone:719-380-7246
Practice Address - Fax:719-380-8282
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-16
Last Update Date:2014-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR0025034207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty