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Contact Information

COMPREHENSIVE PAIN MANAGEMENT OF THE FOX VALLEY, SC
820 E GRANT ST
SUITE 335
APPLETON, WI54911-3490
 Phone: 920-733-7230
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Interventional Pain Medicine

208VP0014X 09 Physician/Interventional Pain Management
 

Durable Medical Equipment & Medical Supplies

332B00000X 54 Other Medical Supply Company
 

Pain Medicine

207LP2900X 05 Physician/Anesthesiology
Indicates primary specialty

NPI Profile & details for COMPREHENSIVE PAIN MANAGEMENT OF THE FOX VALLEY, SC

NPI # 1497810857
LBN Legal business name COMPREHENSIVE PAIN MANAGEMENT OF THE FOX VALLEY, SC
Authorized official ALEXANDER YAKOVLEV - (OWNER/PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 12/26/2006
Last updated 01/24/2013 - About 13 years ago
Identifiers
WI License # 36140-20
WI Medicaid 34086400
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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