Provider Demographics
NPI:1801223268
Name:MEDSPRING PRIME, PA
Entity Type:Organization
Organization Name:MEDSPRING PRIME, PA
Other - Org Name:MEDSPRING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CMO
Authorized Official - Prefix:DR
Authorized Official - First Name:JON
Authorized Official - Middle Name:LESLIE
Authorized Official - Last Name:BELSHER
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:512-402-6235
Mailing Address - Street 1:PO BOX 160247
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78716-0247
Mailing Address - Country:US
Mailing Address - Phone:888-980-0505
Mailing Address - Fax:512-485-7393
Practice Address - Street 1:902 W DUNDEE RD
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60004-7823
Practice Address - Country:US
Practice Address - Phone:312-229-0350
Practice Address - Fax:512-485-7393
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-01
Last Update Date:2013-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care