Healthcare Provider Details

I. General information

NPI: 1720224959
Provider Name (Legal Business Name): CENTER FOR ADVANCED SPINE TECHNOLOGIES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/17/2008
Last Update Date: 04/16/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6905B BURLINGTON PIKE
FLORENCE KY
41042-1618
US

IV. Provider business mailing address

10475 READING RD STE 209
CINCINNATI OH
45241-2563
US

V. Phone/Fax

Practice location:
  • Phone: 513-281-2278
  • Fax: 513-733-1990
Mailing address:
  • Phone: 513-281-2278
  • Fax: 513-221-8219

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207XP3100X
TaxonomyPediatric Orthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateKY
# 5
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. ABUBAKAR ATIQ DURRANI
Title or Position: PRESIDENT
Credential: M.D.
Phone: 513-281-2278