Provider Demographics
NPI:1417361114
Name:OMAHA PAIN SPECIALISTS, LLC
Entity Type:Organization
Organization Name:OMAHA PAIN SPECIALISTS, LLC
Other - Org Name:OMAHA PAIN SPECIALISTS, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:T
Authorized Official - Last Name:BOYD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:402-932-1644
Mailing Address - Street 1:16909 BURKE ST STE 210
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68118-2268
Mailing Address - Country:US
Mailing Address - Phone:402-932-1644
Mailing Address - Fax:402-763-8437
Practice Address - Street 1:16909 BURKE ST STE 210
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68118-2268
Practice Address - Country:US
Practice Address - Phone:402-932-1644
Practice Address - Fax:402-763-8437
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-20
Last Update Date:2015-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty