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Contact Information

IDAHO PAIN CLINIC PLLC
1327 SUPERIOR ST STE 101
SANDPOINT, ID83864-2742
 Phone: 208-965-8118
 Fax: 208-965-8128
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pain Medicine

207LP2900X 05 Physician/Anesthesiology
 

Pain Medicine

2081P2900X 25 Physician/Physical Medicine and Rehabilitation
Indicates primary specialty

NPI Profile & details for IDAHO PAIN CLINIC PLLC

NPI # 1417267329
LBN Legal business name IDAHO PAIN CLINIC PLLC
Authorized official JEFFREY ISPIRESCU - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 10/13/2010
Last updated 01/22/2015 - About 11 years ago
Identifiers
ID Medicaid 3106958
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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