Provider Demographics
NPI:1912207135
Name:WESTERN KENTUCKY PAIN MANAGEMENT CENTER
Entity Type:Organization
Organization Name:WESTERN KENTUCKY PAIN MANAGEMENT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RACHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:FRANKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-746-2444
Mailing Address - Street 1:3515 FREDERICA ST
Mailing Address - Street 2:
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42301-6902
Mailing Address - Country:US
Mailing Address - Phone:270-683-4073
Mailing Address - Fax:270-683-4075
Practice Address - Street 1:3515 FREDERICA ST
Practice Address - Street 2:
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42301-6902
Practice Address - Country:US
Practice Address - Phone:270-683-4073
Practice Address - Fax:270-683-4075
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-22
Last Update Date:2011-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty