MIDSOUTH INTERVENTIONAL PAIN INSTITUTE LLC NPI 1083898605

NPI Information

MIDSOUTH INTERVENTIONAL PAIN INSTITUTE, LLC is an ambulatory surgical clinic center in Southaven, MS. MIDSOUTH INTERVENTIONAL PAIN INSTITUTE, LLC NPI is 1083898605. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Midsouth Pain Treatment Center, Llc.

The provider's business location address is:

122 AIRWAYS PL
SOUTHAVEN, MS
ZIP 38671-872
Phone: (662) 349-9990
Fax: (662) 349-2620

The provider's authorized official is Michael Edward Steuer .
The authorized official title is President/ceo and has the following contact phone number (901) 624-6517.

The CLIA number assigned to this NPI record is 44D1076668 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/18/2007 and was last updated on 4/25/2017.

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:

Other Identifiers

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

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