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Organization

SPINECARE, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. PENNY VAUGHN (ACCOUNT COORDINATOR)
(405) 329-2390
Entity
Organization

Contact information

Practice address
14101 PARKWAY COMMONS DR, OKLAHOMA CITY, OK 73134-6012
(405) 749-2766
(405) 749-6203
Mailing address
PO BOX 114, NORMAN, OK 73070-0114
(405) 329-2390
(405) 329-0486

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
15355
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
447649809003
BLUE CROSS BLUE SHIELD ID
OK
Enumeration date
08/13/2006
Last updated
08/22/2020
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