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Contact Information

BRIDGETON PAIN GROUP
11520 SAINT CHARLES ROCK RD STE 201
BRIDGETON, MO63044
 Phone: 314-526-6093
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

208D00000X 99 Physician/Undefined Physician type[6]
Indicates primary specialty

NPI Profile & details for BRIDGETON PAIN GROUP

NPI # 1114626462
LBN Legal business name BRIDGETON PAIN GROUP
Authorized official MITCHELL LIBERMAN - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 02/27/2023
Last updated 10/30/2023 - About 3 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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