Provider Demographics
NPI:1821445438
Name:PARKWAY BRAIN & SPINE INC.
Entity Type:Organization
Organization Name:PARKWAY BRAIN & SPINE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:R
Authorized Official - Last Name:CARUSO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:724-882-5010
Mailing Address - Street 1:13 WESTERN MARYLAND PKWY
Mailing Address - Street 2:SUITE 106
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21740-6474
Mailing Address - Country:US
Mailing Address - Phone:240-513-4591
Mailing Address - Fax:240-513-4592
Practice Address - Street 1:13 WESTERN MARYLAND PKWY
Practice Address - Street 2:SUITE 106
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-6474
Practice Address - Country:US
Practice Address - Phone:240-513-4591
Practice Address - Fax:240-513-4592
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-24
Last Update Date:2016-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty