Provider Demographics
NPI:1871529206
Name:APM SPINE AND SPORTS PHYSICIANS, P.C.
Entity type:Organization
Organization Name:APM SPINE AND SPORTS PHYSICIANS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:MS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:B
Authorized Official - Last Name:BARR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:757-422-2966
Mailing Address - Street 1:5665 LOWERY ROAD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23502-2220
Mailing Address - Country:US
Mailing Address - Phone:757-422-2966
Mailing Address - Fax:757-422-9241
Practice Address - Street 1:5665 LOWERY ROAD
Practice Address - Street 2:SUITE 100
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502-2220
Practice Address - Country:US
Practice Address - Phone:757-422-2966
Practice Address - Fax:757-422-9241
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-25
Last Update Date:2015-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA001498952081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC03402Medicare UPIN
C03402Medicare PIN