Provider Demographics
NPI:1346589736
Name:INTERVENTIONAL PAIN SOLUTIONS
Entity Type:Organization
Organization Name:INTERVENTIONAL PAIN SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:H
Authorized Official - Last Name:MAUGHON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:205-834-4082
Mailing Address - Street 1:1430 GADSDEN HWY
Mailing Address - Street 2:SUITE 116 - 150
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35235-3126
Mailing Address - Country:US
Mailing Address - Phone:205-834-4082
Mailing Address - Fax:
Practice Address - Street 1:1430 GADSDEN HWY
Practice Address - Street 2:SUITE 116 - 150
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35235-3126
Practice Address - Country:US
Practice Address - Phone:205-834-4082
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-05
Last Update Date:2013-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL21909207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty