Healthcare Provider Details

I. General information

NPI: 1124711585
Provider Name (Legal Business Name): NEURO & SPINE CARE SPECIALISTS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2023
Last Update Date: 06/01/2023
Certification Date: 05/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2050 VERSAILLES RD
LEXINGTON KY
40504-1405
US

IV. Provider business mailing address

PO BOX 1944
LEXINGTON KY
40588-1944
US

V. Phone/Fax

Practice location:
  • Phone: 813-833-3270
  • Fax:
Mailing address:
  • Phone: 813-833-3270
  • Fax: 859-317-8454

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2081P0004X
TaxonomySpinal Cord Injury Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. IHAB LABATIA
Title or Position: OWNER AND PHYSICIAN
Credential: MD
Phone: 813-833-3270