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General NPI Number Information
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NPI Number | 1316902828
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Entity Type | Organization
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Legal Business Name | SPINE AND PAIN CENTER OF NEBRASKA PC
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Dates
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Enumeration Date | 04/18/2006
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Last Update Date | 11/28/2011
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Provider Practice Location Address
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Address Line | 6940 VAN DORN ST SUITE 201
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City | LINCOLN
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State | NE
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Zip | 68506-2858
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Country | US
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Telephone | 402-323-8484
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Fax | 402-323-8599
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Provider Business Mailing Address
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Address Line | 6940 VAN DORN ST SUITE 201
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City | LINCOLN
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State | NE
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Zip | 68506-2858
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Country | US
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Telephone | 402-323-8484
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Fax | 402-323-8599
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOHN R MASSEY
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Credential | MD
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Telephone | 402-323-8484
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number |
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License Number State |
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