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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
151 OCHSNER BLVD STE H, GRETNA, LA 70056-5256
(504) 392-7123
(504) 392-7823
Mailing address
151 OCHSNER BLVD STE H, GRETNA, LA 70056-5256
(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
05
3376644
LA
Enumeration date
10/10/2006
Last updated
07/28/2026
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