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PAIN MANAGEMENT CENTER OF SOUTHERN INDIANA INC. NPI 1629063797


NPI Information

NPI: 1629063797
Provider Name: PAIN MANAGEMENT CENTER OF SOUTHERN INDIANA, INC.
Classification: Clinic/Center - 261QM1300X
Entity Type: Organization

Specialization: Multi-Specialty

Address:
2920 MCINTYRE DR
SUITE 150
BLOOMINGTON, IN
ZIP 47403
Phone: (812) 333-7246
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PAIN MANAGEMENT CENTER OF SOUTHERN INDIANA, INC. is a multi-specialty clinic center in Bloomington, IN. PAIN MANAGEMENT CENTER OF SOUTHERN INDIANA, INC. NPI is 1629063797. The provider is registered as an organization entity type.

The provider's business location address is:

2920 MCINTYRE DR
SUITE 150
BLOOMINGTON, IN
ZIP 47403-221
Phone: (812) 333-7246
Fax: (812) 333-4471

The provider's authorized official is Kamal Kumar Tiwari .
The authorized official title is President and has the following contact phone number (812) 333-7246.

The enumeration date for this NPI number is 9/15/2005 and was last updated on 6/15/2009.


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
1261QM1300XClinic/CenterMulti-Specialty50003765AINDIANAYes

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
1547260MEDICARE PININDIANA
2197890MEDICARE PININDIANA
3100389270MEDICAIDINDIANA
41079250001MEDICARE NSCINDIANA

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: 11/14/2023

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.