Organization
INDIANA SPINE & PAIN INSTITUTE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MANSOOR A KHAN MD (OWNER)
(812) 803-2312
Entity
Organization
Contact information
Practice address
4411 WASHINGTON AVE STE 100, EVANSVILLE, IN 47714-0805
(312) 637-9861
(770) 573-9513
Mailing address
4411 WASHINGTON AVE STE 100, EVANSVILLE, IN 47714-0805
(812) 437-7246
(812) 402-7246
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
—
—
208VP0014X
Interventional Pain Medicine Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
11/22/2017
Last updated
05/31/2019
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