Provider Demographics
NPI:1528009438
Name:SPINE SURGERY INC
Entity Type:Organization
Organization Name:SPINE SURGERY INC
Other - Org Name:SPINE SURGERY INC
Other - Org Type:Other Name
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARSHA
Authorized Official - Middle Name:E
Authorized Official - Last Name:FITZGIBBON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-242-4345
Mailing Address - Street 1:14100 PARKWAY COMMONS DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73134-6015
Mailing Address - Country:US
Mailing Address - Phone:405-242-4345
Mailing Address - Fax:405-242-4333
Practice Address - Street 1:14100 PARKWAY COMMONS DR
Practice Address - Street 2:SUITE 200
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73134-6015
Practice Address - Country:US
Practice Address - Phone:405-242-4345
Practice Address - Fax:405-242-4333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty