Provider Demographics
NPI:1659494748
Name:MAY PAIN INSTITUTE LTD
Entity Type:Organization
Organization Name:MAY PAIN INSTITUTE LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:W
Authorized Official - Last Name:MAY
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:606-258-8185
Mailing Address - Street 1:14 MOONBOW PLAZA
Mailing Address - Street 2:SUITE 2
Mailing Address - City:CORBIN
Mailing Address - State:KY
Mailing Address - Zip Code:40701-8949
Mailing Address - Country:US
Mailing Address - Phone:606-258-8185
Mailing Address - Fax:606-258-8211
Practice Address - Street 1:14 MOONBOW PLAZA
Practice Address - Street 2:SUITE 2
Practice Address - City:CORBIN
Practice Address - State:KY
Practice Address - Zip Code:40701-8949
Practice Address - Country:US
Practice Address - Phone:606-258-8185
Practice Address - Fax:606-258-8211
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY02249207Q00000X, 207QA0401X, 208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Not Answered207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction MedicineGroup - Multi-Specialty
Not Answered208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64022494Medicaid
9987Medicare ID - Type Unspecified
E70371Medicare UPIN