Provider Demographics
NPI:1265731244
Name:ANESTHESIA PAIN MANAGEMENT DOCTORS, LLC
Entity type:Organization
Organization Name:ANESTHESIA PAIN MANAGEMENT DOCTORS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORGANIZEER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:RAPP
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:318-445-7990
Mailing Address - Street 1:77 WOODLAND DR
Mailing Address - Street 2:
Mailing Address - City:BOYCE
Mailing Address - State:LA
Mailing Address - Zip Code:71409-6915
Mailing Address - Country:US
Mailing Address - Phone:318-445-7990
Mailing Address - Fax:
Practice Address - Street 1:233 PECAN PARK AVE
Practice Address - Street 2:SUITE B
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71303-3362
Practice Address - Country:US
Practice Address - Phone:318-427-8090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-16
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.09899R207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1684121Medicaid
LAG39217Medicare UPIN