Provider Demographics
NPI:1477665321
Name:KENTUCKY PAIN PHYSICIANS
Entity Type:Organization
Organization Name:KENTUCKY PAIN PHYSICIANS
Other - Org Name:ROBERT E WINDSOR MD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIANS ASST
Authorized Official - Prefix:
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:
Authorized Official - Last Name:PAYNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-874-0032
Mailing Address - Street 1:286 US HIGHWAY 23 N
Mailing Address - Street 2:STE 102
Mailing Address - City:PRESTONSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:41653-8732
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:286 US HIGHWAY 23 N
Practice Address - Street 2:STE 102
Practice Address - City:PRESTONSBURG
Practice Address - State:KY
Practice Address - Zip Code:41653-8732
Practice Address - Country:US
Practice Address - Phone:606-874-0032
Practice Address - Fax:606-874-0064
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY39994332900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site
Provider Identifiers
StateIdentifier IDID TypeIssuer
1829665OtherOTHER ID NUMBER-COMMERCIAL NUMBER
1829665OtherOTHER ID NUMBER-COMMERCIAL NUMBER