Provider Demographics
NPI:1336215680
Name:AUBURN SPINE & NEUROSURGERY CENTER, PC
Entity Type:Organization
Organization Name:AUBURN SPINE & NEUROSURGERY CENTER, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO M.D.
Authorized Official - Prefix:DR
Authorized Official - First Name:WAYNE
Authorized Official - Middle Name:L
Authorized Official - Last Name:WARREN
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:334-821-0466
Mailing Address - Street 1:560 DEVALL DRIVE
Mailing Address - Street 2:SUITE 301
Mailing Address - City:AUBURN
Mailing Address - State:AL
Mailing Address - Zip Code:36832
Mailing Address - Country:US
Mailing Address - Phone:334-821-0466
Mailing Address - Fax:334-821-4682
Practice Address - Street 1:560 DEVALL DRIVE
Practice Address - Street 2:SUITE 301
Practice Address - City:AUBURN
Practice Address - State:AL
Practice Address - Zip Code:36832
Practice Address - Country:US
Practice Address - Phone:334-821-0466
Practice Address - Fax:334-821-4682
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-28
Last Update Date:2013-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL529928430Medicaid
051557519Medicare PIN
ALH83996Medicare UPIN