FREEDOM SPINE LLC NPI 1134650708

NPI Information

  • NPI: 1134650708
  • Provider Name: FREEDOM SPINE, LLC
  • Classification: Specialist - 174400000X
  • Entity Type: Organization
  • CLIA Number: 19D2145125
  • Address: 29301 N DIXIE RANCH RD
    LACOMBE, LA
    ZIP 70445
  • Phone: (985) 871-4114

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NPI Details

FREEDOM SPINE, LLC is a specialist in Lacombe, LA. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. FREEDOM SPINE, LLC NPI is 1134650708. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

29301 N DIXIE RANCH RD
LACOMBE, LA
ZIP 70445-403
Phone: (985) 871-4114
Fax: (985) 871-4130

The provider's authorized official is John B Logan .
The authorized official title is Owner and has the following contact phone number (985) 871-4114.

The CLIA number assigned to this NPI record is 19D2145125 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/24/2017 and was last updated on 3/24/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1174400000XSpecialistMD.020254LOUISIANAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1F63325MEDICARE UPINLOUISIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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