# ADVANCED SPINE AND PAIN CENTER, P.A.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1376902775
- **Authorized official:** RACHID IDRISSI MD (PHYSICIAN OWNER)
- **Authorized official phone:** (910) 339-8475

## Contact information

- **Practice address:** 518 SANDHURST DR, FAYETTEVILLE, NC 28304-4426
- **Practice address phone:** (910) 339-8475
- **Mailing address:** 518 SANDHURST DR, FAYETTEVILLE, NC 28304-4426

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | — | NULL | Yes |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | — | — | Yes |
| 208VP0000X | Pain Medicine Physician | — | NULL | — |
| 208VP0000X | Pain Medicine Physician | — | — | — |

## Other

- **Enumeration date:** 02/15/2016
- **Last updated:** 02/15/2016