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General NPI Number Information
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NPI Number | 1326920117
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Entity Type | Organization
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Legal Business Name | ELITE NEUROSPINE & VASCULAR INSTITUTE LLC
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Dates
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Enumeration Date | 07/23/2025
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Last Update Date | 09/24/2025
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Provider Practice Location Address
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Address Line | 1118 ROSS CLARK CIR STE 704
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City | DOTHAN
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State | AL
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Zip | 36301-3030
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Country | US
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Telephone | 334-824-3098
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Fax | 334-761-2449
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Provider Business Mailing Address
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Address Line | 1118 ROSS CLARK CIR STE 704
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City | DOTHAN
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State | AL
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Zip | 36301-3030
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Country | US
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Telephone | 334-824-3098
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Fax | 334-761-2449
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOSHUA STERLING BENTLEY
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Credential | D.O.
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Telephone | 334-824-3098
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number |
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License Number State |
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