Provider Demographics
NPI:1568747731
Name:COLUMBUS SPINE SPECIALISTS LLC
Entity Type:Organization
Organization Name:COLUMBUS SPINE SPECIALISTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:SAUD
Authorized Official - Middle Name:
Authorized Official - Last Name:SIDDIQUI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-851-1400
Mailing Address - Street 1:PO BOX 933102
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44193-0014
Mailing Address - Country:US
Mailing Address - Phone:614-851-1400
Mailing Address - Fax:614-851-1444
Practice Address - Street 1:440 INDUSTRIAL MILE RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43228-2411
Practice Address - Country:US
Practice Address - Phone:614-851-1400
Practice Address - Fax:614-851-1444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-19
Last Update Date:2019-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty