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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
2084P2900X
Pain Medicine (Psychiatry & Neurology) Physician
Primary
208VP0014X
Interventional Pain Medicine Physician

Other

Enumeration date
06/05/2024
Last updated
09/11/2024
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