Provider Demographics
NPI:1982960456
Name:ASPEN NEUROSURGERY AND SPINE ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:ASPEN NEUROSURGERY AND SPINE ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:C
Authorized Official - Last Name:BRANAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:877-369-8472
Mailing Address - Street 1:PO BOX 910
Mailing Address - Street 2:
Mailing Address - City:TIJERAS
Mailing Address - State:NM
Mailing Address - Zip Code:87059-0910
Mailing Address - Country:US
Mailing Address - Phone:877-369-8472
Mailing Address - Fax:877-369-8472
Practice Address - Street 1:4801 LANG AVE NE
Practice Address - Street 2:SUITE 110
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-4474
Practice Address - Country:US
Practice Address - Phone:877-369-8472
Practice Address - Fax:877-369-8472
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-09
Last Update Date:2012-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty