Provider Demographics
NPI:1063700862
Name:SPRINGFIELD NEUROLOGICAL AND SPINE INSTITUTE
Entity type:Organization
Organization Name:SPRINGFIELD NEUROLOGICAL AND SPINE INSTITUTE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SVP-PRESIDENT SPRINGFIELD HOSP
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:CASAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:417-269-3102
Mailing Address - Street 1:PO BOX 9434
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65801-9434
Mailing Address - Country:US
Mailing Address - Phone:417-885-3888
Mailing Address - Fax:
Practice Address - Street 1:3535 S NATIONAL AVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65807-7310
Practice Address - Country:US
Practice Address - Phone:417-885-3888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LESTER E. COX MEDICAL CENTERS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-07-13
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit