Healthcare Provider Details

I. General information

NPI: 1881832269
Provider Name (Legal Business Name): NORTH AMERICAN LASERSCOPIC SPINE INSTITUTE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2009
Last Update Date: 01/23/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 ELIZABETH PL
DAYTON OH
45408-1445
US

IV. Provider business mailing address

8150 N CENTRAL EXPY STE 601
DALLAS TX
75206-1877
US

V. Phone/Fax

Practice location:
  • Phone: 800-360-0279
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number057342
License Number StateOH

VIII. Authorized Official

Name: CHRIS H LLOYD
Title or Position: CEO
Credential:
Phone: 214-261-3601