Provider Demographics
NPI:1689621245
Name:ANESTHESIA AND PAIN MANAGEMENT ASSOC., P.A.
Entity Type:Organization
Organization Name:ANESTHESIA AND PAIN MANAGEMENT ASSOC., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JUNE
Authorized Official - Middle Name:
Authorized Official - Last Name:GEHRING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-279-2426
Mailing Address - Street 1:PO BOX 144
Mailing Address - Street 2:
Mailing Address - City:SEARCY
Mailing Address - State:AR
Mailing Address - Zip Code:72145-0144
Mailing Address - Country:US
Mailing Address - Phone:501-279-2426
Mailing Address - Fax:501-279-2501
Practice Address - Street 1:3214 E RACE AVE
Practice Address - Street 2:
Practice Address - City:SEARCY
Practice Address - State:AR
Practice Address - Zip Code:72143-4810
Practice Address - Country:US
Practice Address - Phone:501-268-6121
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-28
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5B700OtherBLUE CROSS BLUE SHIELD
AR127498002Medicaid
CD7786OtherRR MEDICARE
CD7786OtherRR MEDICARE