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Organization
INTERVENTIONAL PAIN & SPINE CENTER PLLC
Active
Organization
INTERVENTIONAL PAIN & SPINE CENTER PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MOHAMMAD KHIZAR ALI MD (AUTHORIZED OFFICIAL)
(724) 965-8946
Entity
Organization
Contact information
Practice address
100 BRADFORD ROAD, STE 410, WEXFORD, PA 15090-8489
(724) 965-8946
(724) 965-8953
Mailing address
100 BRADFORD ROAD, STE 410, WEXFORD, PA 15090-8489
(724) 965-8946
(724) 965-8953
Taxonomy
Speciality
Code
Description
License number
State
2084N0600X
Clinical Neurophysiology Physician
—
NULL
2084N0600X
Clinical Neurophysiology Physician
—
—
2084P2900X
Pain Medicine (Psychiatry & Neurology) Physician
Primary
—
NULL
208VP0014X
Interventional Pain Medicine Physician
—
NULL
208VP0014X
Interventional Pain Medicine Physician
—
—
Other
Enumeration date
06/05/2024
Last updated
09/11/2024
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