Provider Demographics
NPI:1649499609
Name:THE PAIN INSTITUTE
Entity type:Organization
Organization Name:THE PAIN INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:C
Authorized Official - Last Name:CRONEN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:502-423-7366
Mailing Address - Street 1:252 WHITTINGTON PKWY
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40222-4904
Mailing Address - Country:US
Mailing Address - Phone:502-423-7246
Mailing Address - Fax:502-423-7366
Practice Address - Street 1:252 WHITTINGTON PKWY
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40222-4904
Practice Address - Country:US
Practice Address - Phone:502-423-7246
Practice Address - Fax:502-423-7366
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-25
Last Update Date:2007-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY300124261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical