Provider Demographics
NPI:1265679484
Name:COMPLETE PAIN MANAGEMENT, PL
Entity Type:Organization
Organization Name:COMPLETE PAIN MANAGEMENT, PL
Other - Org Name:COMPLETE PAIN MANAGEMENT, PA
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMY
Authorized Official - Middle Name:H
Authorized Official - Last Name:COX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-435-3190
Mailing Address - Street 1:PO BOX 30470
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32503-1470
Mailing Address - Country:US
Mailing Address - Phone:850-435-3190
Mailing Address - Fax:850-435-3199
Practice Address - Street 1:4220 N DAVIS HWY
Practice Address - Street 2:STE A100
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32503-2721
Practice Address - Country:US
Practice Address - Phone:850-435-3190
Practice Address - Fax:850-435-3199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-09
Last Update Date:2009-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty