Provider Demographics
NPI:1003299181
Name:COMPREHENSIVE PAIN TREATMENT LLC
Entity Type:Organization
Organization Name:COMPREHENSIVE PAIN TREATMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:JASON
Authorized Official - Last Name:AIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:316-371-2827
Mailing Address - Street 1:10111 E 21ST ST N STE 106
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67206-3555
Mailing Address - Country:US
Mailing Address - Phone:316-351-7687
Mailing Address - Fax:
Practice Address - Street 1:10111 E 21ST ST N
Practice Address - Street 2:SUITE 106
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67206-3508
Practice Address - Country:US
Practice Address - Phone:316-351-7687
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-07
Last Update Date:2021-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-29063207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100394170BMedicaid
KS100394170BMedicaid