Provider Demographics
NPI:1487024527
Name:DPI PAIN MANAGEMENT LLC
Entity Type:Organization
Organization Name:DPI PAIN MANAGEMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:SIKES
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:225-923-0030
Mailing Address - Street 1:8946 INTERLINE AVE STE C
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-1913
Mailing Address - Country:US
Mailing Address - Phone:225-923-0030
Mailing Address - Fax:225-923-0060
Practice Address - Street 1:4727 W PARK DR
Practice Address - Street 2:SUITE B
Practice Address - City:ZACHARY
Practice Address - State:LA
Practice Address - Zip Code:70791-4090
Practice Address - Country:US
Practice Address - Phone:225-923-0030
Practice Address - Fax:225-923-0060
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-01
Last Update Date:2016-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Single Specialty