Provider Demographics
NPI:1689050528
Name:PAIN & WELLNESS GROUP PSC
Entity Type:Organization
Organization Name:PAIN & WELLNESS GROUP PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:BARRETT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:859-254-5001
Mailing Address - Street 1:185 PASADENA DR
Mailing Address - Street 2:SUITE 215
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-2969
Mailing Address - Country:US
Mailing Address - Phone:859-254-5001
Mailing Address - Fax:
Practice Address - Street 1:185 PASADENA DR
Practice Address - Street 2:SUITE 215
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-2969
Practice Address - Country:US
Practice Address - Phone:859-254-5001
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-03
Last Update Date:2022-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY30184KY208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYF73131KYMedicare UPIN