Organization · NPI-2

Commonwealth Pain Associates PLLC

Non-Pharmacy Dispensing Site · Louisville, KY

NPI number1073134664

StatusActive

Last updated in NPPESMay 6, 2020

Details

NPI: 1073134664
Entity type: Organization (NPI-2)
Legal business name: Commonwealth Pain Associates PLLC
Organization subpart: No
Enumeration date: May 5, 2020
Certification date: May 6, 2020
Last updated: May 6, 2020

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
332900000X	Non-Pharmacy Dispensing Site	–	–	Yes
208VP0014X	Pain Medicine, Interventional Pain Medicine	–	–

Practice location

225 Executive Park
Louisville, KY 40207-4202

Phone 502-855-7200 · Fax 502-855-7201

Mailing address

225 Executive Park
Louisville, KY 40207-4202

Phone 502-855-7200 · Fax 502-855-7201

Authorized official

Jason Carnes Lewis
MD/Owner
5028553919

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