Provider Demographics
NPI:1992223838
Name:PAIN SPECIALISTS PRACTICE MANAGEMENT, INC.
Entity Type:Organization
Organization Name:PAIN SPECIALISTS PRACTICE MANAGEMENT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:JACOBS-MURATTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-492-7246
Mailing Address - Street 1:300 MEDICAL CENTER DR STE 503
Mailing Address - Street 2:
Mailing Address - City:GADSDEN
Mailing Address - State:AL
Mailing Address - Zip Code:35903-1157
Mailing Address - Country:US
Mailing Address - Phone:256-492-7246
Mailing Address - Fax:256-492-5746
Practice Address - Street 1:300 MEDICAL CENTER DR STE 503
Practice Address - Street 2:
Practice Address - City:GADSDEN
Practice Address - State:AL
Practice Address - Zip Code:35903-1157
Practice Address - Country:US
Practice Address - Phone:256-492-7246
Practice Address - Fax:256-492-5746
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty