Provider Type Icon

COASTAL STATES MANAGEMEN NPI 1265440630


NPI Information

NPI: 1265440630
Provider Name: COASTAL STATES MANAGEMEN

Doing Business As: SOUTHEASTERN PAIN MANAGMENT

Classification: Specialist - 174400000X
Entity Type: Organization
Address:
1026 GOODYEAR AVE
BLDG 400, STE 302
GADSDEN, AL
ZIP 35903
Phone: (256) 492-7246
Get Directions

COASTAL STATES MANAGEMEN is a specialist in Gadsden, AL. 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. COASTAL STATES MANAGEMEN NPI is 1265440630. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Southeastern Pain Managment.

The provider's business location address is:

1026 GOODYEAR AVE
BLDG 400, STE 302
GADSDEN, AL
ZIP 35903-102
Phone: (256) 492-7246
Fax: (256) 492-1168

The provider's authorized official is Mary Katherine Jacobs .
The authorized official title is Chief Operating Officer and has the following contact phone number (256) 492-7246.

The enumeration date for this NPI number is 8/3/2006 and was last updated on 8/22/2020.


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
1174400000XSpecialist1294ALABAMAYes

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
105152215RAYOTHERBLUE CROSS BLUE SHIELD

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.