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Contact Information

IC PAIN, LLC
NORTHWEST MEDICAL CENTER
2210 BARRON RD, SUITE 203
POPLAR BLUFF, MD63901
 Phone: 573-776-0157
 Fax: 573-776-6504
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Anesthesiology

207L00000X 79 Physician/Addiction Medicine
Indicates primary specialty

NPI Profile & details for IC PAIN, LLC

NPI # 1477024743
LBN Legal business name IC PAIN, LLC
Authorized official KIP NEWELL - (OWNER/DO)
Entity Organization
Organization subpart 1 No
Enumeration date 12/16/2018
Last updated 12/16/2018 - About 7 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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