Organization
MICROSPINE PHYSICIANS GROUP LLC
Active
Parent organization
MICROSPINE INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
MICROSPINE INC
Authorized official
ANGEL D BARBER (ADMINISTRATOR)
(850) 892-6001
Entity
Organization
Contact information
Practice address
101 MICROSPINE WAY, DEFUNIAK SPRINGS, FL 32435-6323
(850) 892-6001
(850) 892-4212
Mailing address
101 MICROSPINE WAY, DEFUNIAK SPRINGS, FL 32435-6323
(850) 892-6001
(850) 892-4212
Taxonomy
Speciality
Code
Description
License number
State
207RS0010X
Sports Medicine (Internal Medicine) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
34912
BCBS PROVIDER (NONPAR) NU
FL
Enumeration date
05/24/2006
Last updated
10/09/2007
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