Provider Demographics
NPI:1922129899
Name:INTERVENTIONAL PAIN CARE ASSOCIATES, LLC
Entity Type:Organization
Organization Name:INTERVENTIONAL PAIN CARE ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:SABATINO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:317-566-9830
Mailing Address - Street 1:12188A N MERIDIAN ST
Mailing Address - Street 2:SUITE 105
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-4406
Mailing Address - Country:US
Mailing Address - Phone:317-566-9830
Mailing Address - Fax:317-566-9832
Practice Address - Street 1:12188A N MERIDIAN ST
Practice Address - Street 2:SUITE 105
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-4406
Practice Address - Country:US
Practice Address - Phone:317-566-9830
Practice Address - Fax:317-566-9832
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-02
Last Update Date:2009-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01052603A208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200303510Medicaid
IN200491030AMedicaid
IN200303510Medicaid
E88842Medicare UPIN
IN200491030AMedicaid