NORTHEAST ARKANSAS PAIN MEDICINE NPI 1235300765

NPI Information

NORTHEAST ARKANSAS PAIN MEDICINE is an interventional pain medicine pain medicine in Jonesboro, AR. 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. NORTHEAST ARKANSAS PAIN MEDICINE NPI is 1235300765. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

505 E MATTHEWS AVE
SUITE 103
JONESBORO, AR
ZIP 72401-144
Phone: (870) 972-0411
Fax: (870) 933-8011

The provider's authorized official is Monica R Formon .
The authorized official title is Office Manager and has the following contact phone number (870) 972-0411.

The CLIA number assigned to this NPI record is 04D2013619 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 3/12/2008 and was last updated on 12/15/2009.

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:

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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