Tristate Pain Institute

LBN: Tri-State Medical Specialists Llc
Tristate Pain Institute is an health care organization with primary practice located at 1510 E Wagon Wheel Ln Ste 110 , Fort Mohave AZ 86426-6698. The organization recently has 6 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pain Medicine, Allopathic & Osteopathic Physicians / Neurological Surgery, Allopathic & Osteopathic Physicians / Interventional Pain Medicine, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Primary Care. Allopathic & Osteopathic Physicians / Pain Medicine is the primary health care specialty. Tri-State Medical Specialists Llc can be contacted via phone (928) 788-3333, or through Tabora, Knaya via phone (928) 788-3333.

Contact Information

Primary practice address
1510 E Wagon Wheel Ln Ste 110 Fort Mohave AZ 86426-6698
Phone: (928) 788-3333
Fax: (928) 788-3555
Website:
Map and Directions
Authorized official contact:
Name: Tabora, Knaya
Phone: (928) 788-3333

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pain Medicine 207LP2900X
Allopathic & Osteopathic Physicians / Neurological Surgery 207T00000X 20605 Arizona
Allopathic & Osteopathic Physicians / Neurological Surgery 207T00000X 5573 New York
Allopathic & Osteopathic Physicians / Pain Medicine 2081P2900X
Allopathic & Osteopathic Physicians / Pain Medicine 208VP0000X 20605 Arizona
Allopathic & Osteopathic Physicians / Pain Medicine 208VP0000X 5573 Nevada
Allopathic & Osteopathic Physicians / Pain Medicine 208VP0000X
Allopathic & Osteopathic Physicians / Interventional Pain Medicine 208VP0014X
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X AP8599 Arizona
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X AP3760 Arizona
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X AP8599 Arizona
Physician Assistants & Advanced Practice Nursing Providers / Primary Care 363LP2300X AP8599 Arizona

Profile Details

NPI number 1649598426
LBN Legal business name Tri-State Medical Specialists Llc
DBA Doing business as Tristate Pain Institute
Authorized official Tabora, Knaya
Entity Organization
Organization subpart 1 No
Enumeration date May 4th, 2010
Last updated Oct 12th, 2023 - about 3 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 1649598426 NPPES
Arizona MEDICAID 527366
Arizona Other DQ4807

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