| Interventional Pain & Spine Center Pllc | |
|
100 Bradford Road Ste 410 Wexford PA 15090-8489 | |
| (724) 965-8946 | |
| (724) 965-8953 |
| Full Name | Interventional Pain & Spine Center Pllc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 100 Bradford Road, Wexford, Pennsylvania |
| Authorized Official Name and Position | Mohammad Khizar Ali (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 7249658946 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Interventional Pain & Spine Center Pllc 100 Bradford Road Ste 410 Wexford PA 15090-8489 Ph: (724) 965-8946 | Interventional Pain & Spine Center Pllc 100 Bradford Road Ste 410 Wexford PA 15090-8489 Ph: (724) 965-8946 |
| NPI Number | 1114768843 |
|---|---|
| Provider Enumeration Date | 06/05/2024 |
| Last Update Date | 09/11/2024 |
| Certification Date | 09/11/2024 |
| Medicare PECOS PAC ID | 7012452493 |
|---|---|
| Medicare Enrollment ID | O20240925000922 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114768843 | NPI | - | NPPES |
| Provider Name | Mohammad Khizar Ali |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1023428919 PECOS PAC ID: 0941588180 Enrollment ID: I20240925001128 |
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