Provider Demographics
NPI:1790976975
Name:ADVANCED PAIN INSTITUTE, LLC
Entity Type:Organization
Organization Name:ADVANCED PAIN INSTITUTE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MOHAMED
Authorized Official - Middle Name:
Authorized Official - Last Name:ELKERSH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:985-345-7246
Mailing Address - Street 1:42131 VETERANS AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70403-1428
Mailing Address - Country:US
Mailing Address - Phone:985-345-7246
Mailing Address - Fax:985-345-7249
Practice Address - Street 1:42131 VETERANS AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70403-1428
Practice Address - Country:US
Practice Address - Phone:985-345-7246
Practice Address - Fax:985-345-7249
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-05
Last Update Date:2017-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174400000X
LA174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5CY74Medicare PIN
LA6693750001Medicare NSC