Provider Demographics
NPI:1932268844
Name:THE BRAIN & SPINE CENTER PC
Entity type:Organization
Organization Name:THE BRAIN & SPINE CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:O'MALLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:205-621-0122
Mailing Address - Street 1:632 2ND ST NE
Mailing Address - Street 2:
Mailing Address - City:ALABASTER
Mailing Address - State:AL
Mailing Address - Zip Code:35007-8817
Mailing Address - Country:US
Mailing Address - Phone:205-621-0122
Mailing Address - Fax:205-621-0145
Practice Address - Street 1:632 2ND ST NE
Practice Address - Street 2:
Practice Address - City:ALABASTER
Practice Address - State:AL
Practice Address - Zip Code:35007-8817
Practice Address - Country:US
Practice Address - Phone:205-621-0122
Practice Address - Fax:205-621-0145
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2024-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL18447174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALQ02459Medicare UPIN
ALE79257Medicare UPIN
ALF86648Medicare UPIN