Provider Demographics
NPI:1124406350
Name:WEST VIRGINIA PAIN INSTITUTE INC
Entity Type:Organization
Organization Name:WEST VIRGINIA PAIN INSTITUTE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:C
Authorized Official - Last Name:THYMIUS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:304-254-3131
Mailing Address - Street 1:1717 HARPER RD FL 3
Mailing Address - Street 2:
Mailing Address - City:BECKLEY
Mailing Address - State:WV
Mailing Address - Zip Code:25801-3373
Mailing Address - Country:US
Mailing Address - Phone:304-254-3131
Mailing Address - Fax:304-254-3037
Practice Address - Street 1:1717 HARPER RD FL 3
Practice Address - Street 2:
Practice Address - City:BECKLEY
Practice Address - State:WV
Practice Address - Zip Code:25801-3373
Practice Address - Country:US
Practice Address - Phone:304-254-3131
Practice Address - Fax:304-254-3037
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-07
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1729208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty