Provider Demographics
NPI:1558779736
Name:PREFERRED PAIN ASSOCIATES OF ALABAMA, P.C.
Entity Type:Organization
Organization Name:PREFERRED PAIN ASSOCIATES OF ALABAMA, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH ROLAND
Authorized Official - Middle Name:LUC
Authorized Official - Last Name:FRENETTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-508-5300
Mailing Address - Street 1:5057 PINNACLE SQ
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35235-3216
Mailing Address - Country:US
Mailing Address - Phone:205-508-5300
Mailing Address - Fax:205-508-5552
Practice Address - Street 1:5057 PINNACLE SQ
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35235-3216
Practice Address - Country:US
Practice Address - Phone:205-508-5300
Practice Address - Fax:205-508-5552
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-31
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL16051207L00000X
ALAL16501207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000083967OtherBLUE CROSS
AL051511180OtherBLUE CROSS
AL2674OtherHEALTH SPRING OF ALABAMA
MS00127023Medicaid
AL000083967Medicaid
AL010033CE88731OtherSECTION 1011
ALE88731OtherVIVA
AL050045678OtherRAILROAD MEDICARE
MS00127023Medicaid