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Organization
INTERVENTIONAL PAIN SPECIALISTS OF BOWLING GREEN PLC
Active
Organization
INTERVENTIONAL PAIN SPECIALISTS OF BOWLING GREEN PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT KEITH NORMAN CRNA (OWNER/PRESIDENT)
(270) 393-1912
Entity
Organization
Contact information
Practice address
165 NATCHEZ TRACE AVE, SUITE 205, BOWLING GREEN, KY 42103-7940
(270) 393-1912
(270) 393-1913
Mailing address
165 NATCHEZ TRACE AVE, SUITE 205, BOWLING GREEN, KY 42103-7940
(270) 393-1912
(270) 393-1913
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
—
KY
207L00000X
Anesthesiology Physician
—
KY
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
KY
208VP0000X
Pain Medicine Physician
—
KY
208VP0014X
Interventional Pain Medicine Physician
—
KY
363L00000X
Nurse Practitioner
—
KY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
367500000X
Certified Registered Nurse Anesthetist
—
KY
Other
Enumeration date
01/09/2009
Last updated
07/21/2022
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