Provider Demographics
NPI:1538171004
Name:SPINECARE INC
Entity type:Organization
Organization Name:SPINECARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:F
Authorized Official - Last Name:HOUSSAIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:256-461-7775
Mailing Address - Street 1:11743 COUNTY LINE RD STE A
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758-3301
Mailing Address - Country:US
Mailing Address - Phone:256-461-7775
Mailing Address - Fax:256-584-2756
Practice Address - Street 1:11743 COUNTY LINE RD STE A
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-3301
Practice Address - Country:US
Practice Address - Phone:256-461-7775
Practice Address - Fax:256-584-2756
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-13
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1995208VP0000X, 111N00000X, 208VP0000X, 208VP0014X
363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Multi-Specialty
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51505583OtherBLUE CROSS PROVIDER NUMBER
ALU91364Medicare UPIN
AL051505583Medicare PIN