Provider Demographics
NPI:1518297399
Name:ANESTHESIA & PAIN CARE SERVICES, PLLC
Entity Type:Organization
Organization Name:ANESTHESIA & PAIN CARE SERVICES, PLLC
Other - Org Name:RICHMOND PAIN MANAGEMENT CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HAMMAD
Authorized Official - Middle Name:U
Authorized Official - Last Name:MALIK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:859-353-5907
Mailing Address - Street 1:PO BOX 1780
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:KY
Mailing Address - Zip Code:40476-1780
Mailing Address - Country:US
Mailing Address - Phone:859-353-5907
Mailing Address - Fax:859-353-5683
Practice Address - Street 1:1024 IVAL JAMES BLVD
Practice Address - Street 2:SUITE C
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475-7622
Practice Address - Country:US
Practice Address - Phone:859-353-5907
Practice Address - Fax:859-353-5683
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-30
Last Update Date:2015-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY37055208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64055023Medicaid
KY64055023Medicaid