Provider Demographics
NPI:1558594499
Name:PAIN CONSULTANTS OF ALABAMA, LLC
Entity Type:Organization
Organization Name:PAIN CONSULTANTS OF ALABAMA, LLC
Other - Org Name:COMPREHENSIVE PAIN AND REHABILITATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:LAMAR
Authorized Official - Last Name:YEARWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:MD PHD
Authorized Official - Phone:228-938-0700
Mailing Address - Street 1:PO BOX 1469
Mailing Address - Street 2:
Mailing Address - City:PASCAGOULA
Mailing Address - State:MS
Mailing Address - Zip Code:39568-1469
Mailing Address - Country:US
Mailing Address - Phone:228-938-0700
Mailing Address - Fax:228-938-0702
Practice Address - Street 1:4105 HOSPITAL ROAD
Practice Address - Street 2:SUITE 108
Practice Address - City:PASCAGOULA
Practice Address - State:MS
Practice Address - Zip Code:39581-5312
Practice Address - Country:US
Practice Address - Phone:228-938-0700
Practice Address - Fax:228-938-0702
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-26
Last Update Date:2009-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS11988332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment