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Organization
INDIANA PAIN AND SPINE CLINIC CORPORATION
Active
Organization
INDIANA PAIN AND SPINE CLINIC CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AMER M KAZI M.D. (PRESIDENT/OWNER)
(574) 234-2191
Entity
Organization
Contact information
Practice address
6915 N FIR RD, GRANGER, IN 46530-4754
(574) 234-2191
(574) 234-7720
Mailing address
6915 N FIR RD, GRANGER, IN 46530-4754
(574) 234-2191
(574) 234-7720
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
01059304A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000576523
ANTHEM
IN
Enumeration date
06/10/2008
Last updated
02/25/2020
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