Provider Demographics
NPI:1942545546
Name:AMR LLC
Entity Type:Organization
Organization Name:AMR LLC
Other - Org Name:COLUMBUS PAIN SPECIALIST
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/INDEPENDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KHALED
Authorized Official - Middle Name:L
Authorized Official - Last Name:AMR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:614-751-1500
Mailing Address - Street 1:6096 E MAIN ST STE 103
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43213-4302
Mailing Address - Country:US
Mailing Address - Phone:614-751-1500
Mailing Address - Fax:614-751-1501
Practice Address - Street 1:6096 E MAIN ST STE 103
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43213-4302
Practice Address - Country:US
Practice Address - Phone:614-751-1500
Practice Address - Fax:614-751-1501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-07
Last Update Date:2012-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2084P0800X2084P2900X
OHE 0007908208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Single Specialty
No2084P2900XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPain MedicineGroup - Single Specialty