Provider Demographics
NPI:1255549804
Name:TRIANGLE SPINE AND BACK CARE CENTER, PLLC
Entity type:Organization
Organization Name:TRIANGLE SPINE AND BACK CARE CENTER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:FRANCIS
Authorized Official - Last Name:LESTINI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:919-876-7676
Mailing Address - Street 1:3320 WAKE FOREST RD
Mailing Address - Street 2:SUITE 430
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-7300
Mailing Address - Country:US
Mailing Address - Phone:919-876-7676
Mailing Address - Fax:919-876-7163
Practice Address - Street 1:3320 WAKE FOREST RD
Practice Address - Street 2:SUITE 430
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-7300
Practice Address - Country:US
Practice Address - Phone:919-876-7676
Practice Address - Fax:919-876-7163
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-18
Last Update Date:2008-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC35960207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC02196OtherBCBS GROUP
NC7902196Medicaid
NC2313777Medicare ID - Type Unspecified