Provider Demographics
NPI:1710591060
Name:MIDSOUTH INTERVENTIONAL PAIN INSTITUTE, LLC
Entity Type:Organization
Organization Name:MIDSOUTH INTERVENTIONAL PAIN INSTITUTE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:STEUER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:731-664-1773
Mailing Address - Street 1:2016 GREYSTONE SQ
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38305-3575
Mailing Address - Country:US
Mailing Address - Phone:662-349-9990
Mailing Address - Fax:
Practice Address - Street 1:2016 GREYSTONE SQ
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38305-3575
Practice Address - Country:US
Practice Address - Phone:662-349-9990
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-03
Last Update Date:2021-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical