Provider Demographics
NPI:1316902828
Name:SPINE AND PAIN CENTER OF NEBRASKA PC
Entity type:Organization
Organization Name:SPINE AND PAIN CENTER OF NEBRASKA PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:R
Authorized Official - Last Name:MASSEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:402-323-8484
Mailing Address - Street 1:6940 VAN DORN ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-2858
Mailing Address - Country:US
Mailing Address - Phone:402-323-8484
Mailing Address - Fax:402-323-8599
Practice Address - Street 1:6940 VAN DORN ST
Practice Address - Street 2:SUITE 201
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-2858
Practice Address - Country:US
Practice Address - Phone:402-323-8484
Practice Address - Fax:402-323-8599
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-18
Last Update Date:2011-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Single Specialty