Organization
SPINECARE MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALEXIS M WAGUESPACK MD (MD)
(504) 392-7123
Entity
Organization
Contact information
Practice address
3939 HOUMA BLVD STE 18, METAIRIE, LA 70006-2921
(504) 392-7123
(504) 392-7823
Mailing address
3939 HOUMA BLVD STE 18, METAIRIE, LA 70006-2921
(504) 392-7123
(504) 392-7823
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
09377R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1955884
—
LA
Enumeration date
10/10/2006
Last updated
02/07/2024
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