Provider Demographics
NPI:1841694577
Name:MIDWEST SPINE & PAIN CONSULTANTS
Entity type:Organization
Organization Name:MIDWEST SPINE & PAIN CONSULTANTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:DR
Authorized Official - First Name:JIMMY
Authorized Official - Middle Name:M
Authorized Official - Last Name:HENRY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:844-677-2378
Mailing Address - Street 1:5051 FOREST DR
Mailing Address - Street 2:
Mailing Address - City:NEW ALBANY
Mailing Address - State:OH
Mailing Address - Zip Code:43054-8181
Mailing Address - Country:US
Mailing Address - Phone:844-677-2378
Mailing Address - Fax:855-827-9978
Practice Address - Street 1:5051 FOREST DR
Practice Address - Street 2:
Practice Address - City:NEW ALBANY
Practice Address - State:OH
Practice Address - Zip Code:43054
Practice Address - Country:US
Practice Address - Phone:844-677-2378
Practice Address - Fax:855-827-9978
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-08
Last Update Date:2020-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain