Organization
NEUROSPINE GROUP
Active
Other names
The Neurospine Group
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE LEISHMAN (CREDENTIALING SPECIALIST)
(541) 316-6616
Entity
Organization
Contact information
Practice address
74B CENTENNIAL LOOP STE 300, EUGENE, OR 97401-7925
(541) 686-3791
(541) 686-3795
Mailing address
74B CENTENNIAL LOOP STE 300, EUGENE, OR 97401-7925
(541) 316-6616
(541) 284-3160
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1033192760
COMMERCIAL
OR
05
—
1033192760
—
OR
01
—
1033283627
COMMERCIAL
OR
05
—
1033283627
—
OR
01
—
1184634594
COMMERCIAL
OR
05
—
1184634594
—
OR
01
—
1477536100
COMMERCIAL
OR
05
—
1477536100
—
OR
05
—
1518639038
—
OR
01
—
1831475573
COMMERCIAL
OR
05
—
1831475573
—
OR
01
—
1902000599
COMMERCIAL
OR
05
—
1902000599
—
OR
01
—
1982899274
COMMERCIAL
OR
05
—
1982899274
—
OR
Enumeration date
07/16/2018
Last updated
07/21/2022
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