Provider Demographics
NPI:1841072162
Name:INTERVENTIONAL PAIN AND REGENERATIVE MEDICINE SPECIALISTS
Entity type:Organization
Organization Name:INTERVENTIONAL PAIN AND REGENERATIVE MEDICINE SPECIALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:HUFFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:571-732-0044
Mailing Address - Street 1:1635 N GEORGE MASON DR STE 150
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22205-3679
Mailing Address - Country:US
Mailing Address - Phone:571-732-0044
Mailing Address - Fax:866-850-1049
Practice Address - Street 1:1635 N GEORGE MASON DR STE 150
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22205-3679
Practice Address - Country:US
Practice Address - Phone:571-732-0044
Practice Address - Fax:866-850-1049
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-20
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty