Provider Demographics
NPI:1639545940
Name:ELITE PAIN MANAGEMENT, LLC
Entity Type:Organization
Organization Name:ELITE PAIN MANAGEMENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:M
Authorized Official - Last Name:TONKIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:417-848-9188
Mailing Address - Street 1:222 E PRIMROSE ST STE E
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65807-5233
Mailing Address - Country:US
Mailing Address - Phone:417-888-0167
Mailing Address - Fax:417-888-0189
Practice Address - Street 1:7150 W SUNSET RD STE 202
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89113-1981
Practice Address - Country:US
Practice Address - Phone:702-514-1411
Practice Address - Fax:702-514-1413
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-20
Last Update Date:2019-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Multi-Specialty