National Provider Identifier Database

WILLOW PAIN AND WELLNESS LLC
Pain


Contact Information

WILLOW PAIN AND WELLNESS, LLC
255 MEDICAL CENTER DR.
BATESVILLE, MS38606
Phone: 662-638-0462
Fax: 866-658-0083
Website:
Specialty Taxonomy Code
* Pain 261QP3300X

* Indicates primary specialty

NPI Profile & details for WILLOW PAIN AND WELLNESS, LLC

NPI Number 1104300854
Legal business name
LBN
WILLOW PAIN AND WELLNESS, LLC
Authorized official KIRK KINARD - (OWNER/ MEDICAL DIRECTOR)
Entity Organization
Organization subpart Yes
Enumeration date 09/19/2018
Last updated 09/19/2018 - About 8 years ago
Sole proprietor1 Not specified
Identifiers
  • MS Medicaid: 04159271

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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