# BRIDGEPORT PAIN CLINIC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1033372867
- **Authorized official:** DR. MANUEL POUPARINAS M.D. (OWNER)
- **Authorized official phone:** (256) 437-8188

## Contact information

- **Practice address:** 47053 AL HIGHWAY 277, SUITE B, BRIDGEPORT, AL 35740-7205
- **Practice address phone:** (256) 437-8188
- **Practice address fax:** (256) 437-8189
- **Mailing address:** 47053 AL HIGHWAY 277, SUITE B, BRIDGEPORT, AL 35740-7205
- **Mailing address phone:** (256) 437-8188
- **Mailing address fax:** (256) 437-8189

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | 28396 | AL | Yes |

## Other

- **Enumeration date:** 07/02/2008
- **Last updated:** 07/02/2008