# CRYSTAL COAST PAIN MANAGEMENT CENTER, PLLC

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

## Provider details

- **NPI number:** 1093209546
- **Authorized official:** SUSAN JONES (MGR)
- **Authorized official phone:** (252) 636-0300

## Contact information

- **Practice address:** 5053 EXECUTIVE DR STE B, MOREHEAD CITY, NC 28557
- **Practice address phone:** (252) 726-8480
- **Mailing address:** 2111 NEUSE BLVD STE J, NEW BERN, NC 28560-4318
- **Mailing address phone:** (125) 263-6030

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | NULL | Yes |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/19/2018
- **Last updated:** 07/25/2018