Provider Demographics
NPI:1578036448
Name:MINIMALLY INVASIVE SPINE INSTITUTE PLLC
Entity type:Organization
Organization Name:MINIMALLY INVASIVE SPINE INSTITUTE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:C
Authorized Official - Last Name:ANAGNOST
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:918-701-2000
Mailing Address - Street 1:PO BOX 702006
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74170-2006
Mailing Address - Country:US
Mailing Address - Phone:918-701-2000
Mailing Address - Fax:866-344-3971
Practice Address - Street 1:2811 E 15TH ST STE 102
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74104-5242
Practice Address - Country:US
Practice Address - Phone:918-701-2000
Practice Address - Fax:866-344-3971
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-03
Last Update Date:2025-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Single Specialty