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COMPREHENSIVE PAIN CENTER OF MISSISSIPPI NPI 1124275565


NPI Information

NPI: 1124275565
Provider Name: COMPREHENSIVE PAIN CENTER OF MISSISSIPPI
Classification: Pain Medicine - 208VP0014X
Entity Type: Organization

Specialization: Interventional Pain Medicine

CLIA Number: 25D2062254

Address:
129 FOUNTAINS BLVD
MADISON, MS
ZIP 39110
Phone: (769) 300-0730
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COMPREHENSIVE PAIN CENTER OF MISSISSIPPI is an interventional pain medicine pain medicine in Madison, MS. The provider is interventional Pain Medicine is the discipline of medicine devoted to the diagnosis and treatment of pain and related disorders principally with the application of interventional techniques in managing subacute, chronic, persistent, and intractable pain, independently or in conjunction with other modalities of treatment. COMPREHENSIVE PAIN CENTER OF MISSISSIPPI NPI is 1124275565. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

129 FOUNTAINS BLVD
MADISON, MS
ZIP 39110
Phone: (769) 300-0730
Fax: (601) 949-2782

The provider's authorized official is Leonel Kevin Vance .
The authorized official title is Owner and has the following contact phone number (769) 300-0730.

The CLIA number assigned to this NPI record is 25D2062254 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/27/2008 and was last updated on 10/25/2021.


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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208VP0014XPain MedicineInterventional Pain Medicine16855MISSISSIPPIYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
12389791MEDICAIDMISSISSIPPI

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: 5/5/2024

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