Provider Demographics
NPI:1497322093
Name:INTEGRATED PAIN SOLUTIONS INCORPORATED
Entity Type:Organization
Organization Name:INTEGRATED PAIN SOLUTIONS INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GLADSTONE
Authorized Official - Middle Name:C
Authorized Official - Last Name:MCDOWELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:614-383-6450
Mailing Address - Street 1:1210 GEMINI PL STE 300
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43240-6112
Mailing Address - Country:US
Mailing Address - Phone:614-383-6450
Mailing Address - Fax:
Practice Address - Street 1:1117 E HOME RD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45503-2725
Practice Address - Country:US
Practice Address - Phone:614-383-6450
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-10
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty