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Organization
RDK PAIN MANAGEMENT LLC
Active
Organization
RDK PAIN MANAGEMENT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICKEY D. KINZEY D.O. (SOLE MEMBER/OWNER)
(812) 941-8635
Entity
Organization
Contact information
Practice address
2580 CHARLESTOWN RD, NEW ALBANY, IN 47150-2555
(812) 941-8635
(812) 941-8630
Mailing address
2580 CHARLESTOWN RD, NEW ALBANY, IN 47150-2555
(812) 941-8630
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
02000860A
IN
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000368845
RKP ANTHEM
IN
01
—
000000368855
RKA ANTHEM
IN
05
—
100446040
—
IN
Enumeration date
12/03/2012
Last updated
05/18/2016
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