Provider Demographics
NPI:1659312007
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:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:HUNTINGTON
Authorized Official - Middle Name:TAPPIN
Authorized Official - Last Name:HAPWORTH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
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:228-938-0699
Mailing Address - Fax:228-938-0705
Practice Address - Street 1:4105 HOSPITAL ST
Practice Address - Street 2:SUITE 112B
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:228-938-0705
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-09
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00015545208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MSC03238Medicare PIN
ALJ301Medicare PIN