Northeast Arkansas Pain Medicine

LBN: Northeast Arkansas Pain Medicine
Northeast Arkansas Pain Medicine is an health care organization with primary practice located at 505 E Matthews Ave Suite 103, Jonesboro AR 72401-3144. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Interventional Pain Medicine, which is considered as the primary health care specialty. Northeast Arkansas Pain Medicine can be contacted via phone (870) 972-0411, or through Formon, Monica R via phone (870) 972-0411.

Contact Information

Primary practice address
505 E Matthews Ave Suite 103 Jonesboro AR 72401-3144
Phone: (870) 972-0411
Fax: (870) 933-8011
Website:
Map and Directions
Authorized official contact:
Name: Formon, Monica R
Phone: (870) 972-0411

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Interventional Pain Medicine 208VP0014X E1479 Arkansas

Profile Details

NPI number 1235300765
LBN Legal business name Northeast Arkansas Pain Medicine
DBA Doing business as
Authorized official Formon, Monica R
Entity Organization
Organization subpart 1 No
Enumeration date Mar 12th, 2008
Last updated Dec 15th, 2009 - about 17 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1235300765 NPPES
Arkansas MEDICAID 143853002
Arkansas Other 5K398

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