Provider Demographics
NPI:1386830420
Name:COMPREHENSIVE SPINE CARE AND ORTHOPEDIC SURGERY, PLLC
Entity Type:Organization
Organization Name:COMPREHENSIVE SPINE CARE AND ORTHOPEDIC SURGERY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:A
Authorized Official - Last Name:SEYBOLD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:607-773-2225
Mailing Address - Street 1:65 PENNSYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:BINGHAMTON
Mailing Address - State:NY
Mailing Address - Zip Code:13903-1608
Mailing Address - Country:US
Mailing Address - Phone:607-773-2225
Mailing Address - Fax:607-754-1477
Practice Address - Street 1:65 PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:BINGHAMTON
Practice Address - State:NY
Practice Address - Zip Code:13903-1608
Practice Address - Country:US
Practice Address - Phone:607-773-2225
Practice Address - Fax:607-754-1477
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-22
Last Update Date:2007-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX009073-1111N00000X
NY209065-1207XS0117X
NY230204-1208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty