# RDK PAIN MANAGEMENT LLC

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

## Provider details

- **NPI number:** 1033454012
- **Authorized official:** RICKEY D. KINZEY D.O. (SOLE MEMBER/OWNER)
- **Authorized official phone:** (812) 941-8635

## Contact information

- **Practice address:** 2580 CHARLESTOWN RD, NEW ALBANY, IN 47150-2555
- **Practice address phone:** (812) 941-8635
- **Practice address fax:** (812) 941-8630
- **Mailing address:** 2580 CHARLESTOWN RD, NEW ALBANY, IN 47150-2555
- **Mailing address fax:** (812) 941-8630

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | 02000860A | IN | Yes |
| 363L00000X | Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 12/03/2012
- **Last updated:** 05/18/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000000368845 | RKP ANTHEM | IN |
| 01 | — | 000000368855 | RKA ANTHEM | IN |
| 05 | — | 100446040 | — | IN |