Provider Demographics
NPI:1992986376
Name:PLEDGER ORTHOPEDIC & SPINE CENTER INC
Entity type:Organization
Organization Name:PLEDGER ORTHOPEDIC & SPINE CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:ROY
Authorized Official - Last Name:PLEDGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:513-727-2538
Mailing Address - Street 1:5900 LONG MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:OH
Mailing Address - Zip Code:45005-9687
Mailing Address - Country:US
Mailing Address - Phone:513-420-3773
Mailing Address - Fax:513-727-2539
Practice Address - Street 1:5900 LONG MEADOW DR
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:OH
Practice Address - Zip Code:45005-9687
Practice Address - Country:US
Practice Address - Phone:513-420-3773
Practice Address - Fax:513-727-2539
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-14
Last Update Date:2011-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Single Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2998967Medicaid
OH0333151Medicaid
OH2998967Medicaid
OH0333151Medicaid
OH5779480001Medicare NSC