Provider Demographics
NPI:1972748697
Name:MICROSPINE ORTHOPEDIC PHYSICIANS LLC
Entity Type:Organization
Organization Name:MICROSPINE ORTHOPEDIC PHYSICIANS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANGEL
Authorized Official - Middle Name:D
Authorized Official - Last Name:BARBER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-892-6001
Mailing Address - Street 1:101 MICROSPINE WAY
Mailing Address - Street 2:
Mailing Address - City:DEFUNIAK SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32435-6323
Mailing Address - Country:US
Mailing Address - Phone:850-892-6001
Mailing Address - Fax:
Practice Address - Street 1:101 MICROSPINE WAY
Practice Address - Street 2:
Practice Address - City:DEFUNIAK SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32435-6323
Practice Address - Country:US
Practice Address - Phone:850-892-6001
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MICROPINE INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-12-09
Last Update Date:2008-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Single Specialty