Organization · NPI-2

Alabama Pain Center, LLC

Anesthesiology, Pain Medicine · Huntsville, AL

NPI number1831265776
StatusActive
Last updated in NPPESAug 15, 2012

Details

NPI
1831265776
Entity type
Organization (NPI-2)
Legal business name
Alabama Pain Center, LLC
Organization subpart
No
Enumeration date
Nov 24, 2006
Last updated
Aug 15, 2012

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207LP2900X Anesthesiology, Pain Medicine12320ALYes
103TC0700X Psychologist, Clinical895AL
363L00000X Nurse Practitioner1-075145AL

Practice location

600 Whitesport Drive
Suite A
Huntsville, AL 35801

Phone 256-882-2003 · Fax 256-705-4630

Mailing address

600 Whitesport Drive
Suite A
Huntsville, AL 35801

Phone 256-882-2003 · Fax 256-705-4630

Authorized official

Kenneth Dean Willis
Medical Director
2568822003

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