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Organization

NEUROSPINE INSTITUTE LLC

Active
Other names
Neurosurgery Associates
Organization subpart
No

Provider details

NPI number
Authorized official
NICOLE LEISHMAN (CREDENTIALING SPECIALIST)
(541) 686-3791
Entity
Organization

Contact information

Practice address
74B CENTENNIAL LOOP, SUITE 100, EUGENE, OR 97401-7918
(541) 686-3791
(541) 686-3795
Mailing address
74B CENTENNIAL LOOP STE 300, EUGENE, OR 97401-7925
(541) 686-3791
(541) 686-3795

Taxonomy

Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
207XS0117X
Orthopaedic Surgery of the Spine Physician
208VP0000X
Pain Medicine Physician

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
005818
OR
Enumeration date
05/04/2006
Last updated
05/09/2022
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