Organization
MICROSPINE PHYSICIANS GROUP LLC
Active
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
Update your record
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