LAUREL PAIN CLINIC PA NPI 1811098874

NPI Information

  • NPI: 1811098874
  • Provider Name: LAUREL PAIN CLINIC PA
  • Classification: Pain Medicine - 208VP0014X
  • Specialization: Interventional Pain Medicine
  • Entity Type: Organization
  • CLIA Number: 25D1072565
  • Address: 1706 W 12TH ST
    LAUREL, MS
    ZIP 39440
  • Phone: (601) 369-2021

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NPI Details

LAUREL PAIN CLINIC PA is an interventional pain medicine pain medicine in Laurel, 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. LAUREL PAIN CLINIC PA NPI is 1811098874. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1706 W 12TH ST
LAUREL, MS
ZIP 39440-559
Phone: (601) 369-2021

The provider's authorized official is Ashley N Buie .
The authorized official title is Billing Supervisor and has the following contact phone number (601) 898-7530.

The CLIA number assigned to this NPI record is 25D1072565 - physician office with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 9/25/2006 and was last updated on 11/6/2012.

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 Medicine16318MISSISSIPPIYes

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
1DF1770OTHERMISSISSIPPIRAILROAD MEDICARE
2CO3320MEDICARE ID-TYPE UNSPECIFIEDMISSISSIPPI
309987586MEDICAIDMISSISSIPPI

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: 11/21/2025

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