Provider Demographics
NPI:1568475689
Name:GATEWAY PAIN CENTER INC
Entity Type:Organization
Organization Name:GATEWAY PAIN CENTER INC
Other - Org Name:INJURY SPECIALISTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:A
Authorized Official - Last Name:FEINBERG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:314-985-3002
Mailing Address - Street 1:10435 CLAYTON RD
Mailing Address - Street 2:SUITE 120
Mailing Address - City:FRONTENAC
Mailing Address - State:MO
Mailing Address - Zip Code:63131-2909
Mailing Address - Country:US
Mailing Address - Phone:314-985-3002
Mailing Address - Fax:314-985-3012
Practice Address - Street 1:10435 CLAYTON RD
Practice Address - Street 2:SUITE 120
Practice Address - City:FRONTENAC
Practice Address - State:MO
Practice Address - Zip Code:63131-2909
Practice Address - Country:US
Practice Address - Phone:314-985-3002
Practice Address - Fax:314-985-3012
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-14
Last Update Date:2016-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO503278707Medicaid
MO7566030001Medicare NSC
MO000011300Medicare ID - Type UnspecifiedGROUP PROVIDER NUMBER