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SOUTHERN PAIN AND REHABILITATION INC NPI 1295377497


NPI Information

NPI: 1295377497
Provider Name: SOUTHERN PAIN AND REHABILITATION INC

Doing Business As: ELITE PAIN AND SPINE

Classification: Physical Medicine & Rehabilitation - 2081P2900X
Entity Type: Organization

Specialization: Pain Medicine

CLIA Number: 18D2189554

Address:
4645 VILLAGE SQUARE DR STE C
PADUCAH, KY
ZIP 42001
Phone: (270) 228-0118
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SOUTHERN PAIN AND REHABILITATION INC is a pain medicine physical medicine rehabilitation in Paducah, KY. The provider is a physician who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic or cancer pain in both hospital and ambulatory settings. Patient care needs may also be coordinated with other specialists. SOUTHERN PAIN AND REHABILITATION INC NPI is 1295377497. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Elite Pain And Spine.

The provider's business location address is:

4645 VILLAGE SQUARE DR STE C
PADUCAH, KY
ZIP 42001-448
Phone: (270) 228-0118

The provider's authorized official is John T Ruxer .
The authorized official title is President and has the following contact phone number (812) 639-9453.

The CLIA number assigned to this NPI record is 18D2189554 - physician office with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 10/9/2019 and was last updated on 5/24/2021.


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
1208100000XPhysical Medicine & RehabilitationNo
22081P2900XPhysical Medicine & RehabilitationPain MedicineYes
3332B00000XDurable Medical Equipment & Medical SuppliesNo
4363LF0000XNurse PractitionerFamilyNo
5363LG0600XNurse PractitionerGerontologyNo

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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