Provider Demographics
NPI:1477106771
Name:SPINE CENTER OF SOUTHEAST GEORGIA LLC
Entity type:Organization
Organization Name:SPINE CENTER OF SOUTHEAST GEORGIA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RCM SR. DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:FINKLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-243-9490
Mailing Address - Street 1:4960 SW 72ND AVE STE 405
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-5506
Mailing Address - Country:US
Mailing Address - Phone:469-458-9222
Mailing Address - Fax:540-918-7202
Practice Address - Street 1:52A LINDSEY LANE
Practice Address - Street 2:
Practice Address - City:KINGSLAND
Practice Address - State:GA
Practice Address - Zip Code:31548-6855
Practice Address - Country:US
Practice Address - Phone:912-262-6552
Practice Address - Fax:912-262-0112
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-17
Last Update Date:2025-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty