Provider Demographics
NPI:1710262464
Name:COMPREHENSIVE SPINE CARE, PC
Entity Type:Organization
Organization Name:COMPREHENSIVE SPINE CARE, PC
Other - Org Name:COMPREHENSIVE SPINE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINICAL DIRECTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:B
Authorized Official - Last Name:ROBSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:314-991-7707
Mailing Address - Street 1:3009 N BALLAS RD
Mailing Address - Street 2:STE 320A
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63131-2322
Mailing Address - Country:US
Mailing Address - Phone:314-991-7707
Mailing Address - Fax:314-432-2392
Practice Address - Street 1:3009 N BALLAS RD
Practice Address - Street 2:STE 320A
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63131-2322
Practice Address - Country:US
Practice Address - Phone:314-991-7707
Practice Address - Fax:314-432-2392
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-13
Last Update Date:2011-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOMA3719Medicare PIN