COMPREHENSIVE PAIN CENTER FOR SURGERY NPI 1487094058

NPI Information

NPI: 1487094058
Provider Name: COMPREHENSIVE PAIN CENTER FOR SURGERY

Doing Business As: FOUNTAINS SPECIALTY SURGICAL CENTER

Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

Address:
129 FOUNTAINS BLVD.
MADISON, MS
ZIP 39110
Phone: (769) 300-0720
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COMPREHENSIVE PAIN CENTER FOR SURGERY is an ambulatory surgical clinic center in Madison, MS. COMPREHENSIVE PAIN CENTER FOR SURGERY NPI is 1487094058. The provider is registered as an organization entity type.
The provider Is Doing Business As Fountains Specialty Surgical Center.

The provider's business location address is:

129 FOUNTAINS BLVD.
MADISON, MS
ZIP 39110
Phone: (769) 300-0720
Fax: (769) 300-0721

The provider's authorized official is Leonel K Vance .
The authorized official title is Medical Director and has the following contact phone number (769) 300-0720.

The enumeration date for this NPI number is 6/27/2013 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
1	261QA1903X	Clinic/Center	Ambulatory Surgical		MISSISSIPPI	Yes

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
1	1525725	MEDICAID	MISSISSIPPI

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

NPI Synchronization or Removal

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