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828 WALK IN CLINIC NPI 1255608816


NPI Information

NPI: 1255608816
Provider Name: 828 WALK IN CLINIC

Doing Business As: PAINSTOP SPINE CLINIC, LLC

Classification: Anesthesiology - 207LP2900X
Entity Type: Organization

Specialization: Pain Medicine

CLIA Number: 25D2030206

Address:
12207 HWY 49
SUITE 40
GULFPORT, MS
ZIP 39503
Phone: (228) 832-8872
Get Directions

828 WALK IN CLINIC is a pain medicine anesthesiology in Gulfport, MS. The provider is an anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic and/or cancer pain in both hospital and ambulatory settings. Patient care needs are also coordinated with other specialists. 828 WALK IN CLINIC NPI is 1255608816. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Painstop Spine Clinic, Llc.

The provider's business location address is:

12207 HWY 49
SUITE 40
GULFPORT, MS
ZIP 39503
Phone: (228) 832-8872
Fax: (866) 809-7246

The provider's authorized official is Stacey M Tsang .
The authorized official title is General Manager and has the following contact phone number (228) 273-4096.

The CLIA number assigned to this NPI record is 25D2030206 - physician office with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 11/28/2011 and was last updated on 11/28/2011.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1363L00000XNurse PractitionerR791344MISSISSIPPINo
2207LP2900XAnesthesiologyPain Medicine14282MISSISSIPPIYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
104078379MEDICAIDMISSISSIPPI
2050000673MEDICARE PINMISSISSIPPI
3F01599MEDICARE UPINMISSISSIPPI
4500001505MEDICARE PINMISSISSIPPI
5Q16854MEDICARE UPINMISSISSIPPI
600114733MEDICAIDMISSISSIPPI

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: 4/28/2024

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