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Organization
AXIS SPINE PLLC
Active
Organization
AXIS SPINE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA JAMESON (MD / OWNER)
(208) 457-4208
Entity
Organization
Contact information
Practice address
1641 E POLSTON AVE, SUITE 101, POST FALLS, ID 83854-7852
(208) 457-4208
(208) 457-4197
Mailing address
1641 E POLSTON AVE, SUITE 101, POST FALLS, ID 83854-7852
(208) 457-4208
(208) 457-4197
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
NULL
207L00000X
Anesthesiology Physician
—
—
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
NULL
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
208600000X
Surgery Physician
—
NULL
208600000X
Surgery Physician
—
—
208VP0000X
Pain Medicine Physician
Primary
—
NULL
208VP0000X
Pain Medicine Physician
Primary
—
—
363A00000X
Physician Assistant
—
NULL
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
NULL
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
11/17/2016
Last updated
04/14/2017
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