Healthcare Provider Details

I. General information

NPI: 1023860574
Provider Name (Legal Business Name): SPINE CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/05/2024
Last Update Date: 05/19/2025
Certification Date: 05/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9001 SUMMA AVE STE 346
BATON ROUGE LA
70809-3779
US

IV. Provider business mailing address

9001 SUMMA AVE STE 346
BATON ROUGE LA
70809-3779
US

V. Phone/Fax

Practice location:
  • Phone: 225-515-5700
  • Fax:
Mailing address:
  • Phone: 225-515-5700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. NAVID PAPEHN
Title or Position: ADMINISTRATION
Credential:
Phone: 818-642-1170