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Contact Information

SOUTHERN PAIN AND REGENERATIVE MEDICINE PC
8990 GERMANTOWN RD STE B
OLIVE BRANCH, MS38654-8532
 Phone: 662-775-0189
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Interventional Pain Medicine

208VP0014X 09 Physician/Interventional Pain Management
 

Family

363LF0000X 50 Nurse Practitioner
 

Physician Assistant

363A00000X 97 Physician Assistant
 

Vascular & Interventional Radiology

2085R0204X 94 Physician/Interventional Radiology
Indicates primary specialty

NPI Profile & details for SOUTHERN PAIN AND REGENERATIVE MEDICINE PC · (Female)

NPI Number 1841799707
Status Active
Credentials
Entity Individual
Enumeration date 02/06/2018
Last updated 01/12/2026 - About 5 months ago
Sole proprietor 1 Not specified
Identifiers
  • TN License # MD20801
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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