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Organization
TOTAL PAIN CARE LLC
Active
Organization
TOTAL PAIN CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH E STAGGS JR. MD (PRESIDENT TOTAL PAIN CARE LLC)
(601) 482-9224
Entity
Organization
Contact information
Practice address
1001 14TH STREET, MERIDIAN, MS 39301
(601) 703-3076
(601) 703-4586
Mailing address
PO BOX 711, MERIDIAN, MS 39302-0711
(601) 703-3076
(601) 703-4586
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20248443
BCBS MISSISSIPPI
MS
05
—
ASC0076C
—
AL
Enumeration date
07/08/2006
Last updated
08/22/2020
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