# PAIN CARE SURGERY, PC

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

## Provider details

- **NPI number:** 1184690570
- **Authorized official:** DR. LAXMAIAH MANCHIKANTI M.D. (MEDICAL DIRECTOR)
- **Authorized official phone:** (618) 997-7820

## Contact information

- **Practice address:** 108 AIRWAY DR, MARION, IL 62959-5841
- **Practice address phone:** (618) 997-7820
- **Practice address fax:** (618) 997-6721
- **Mailing address:** 108 AIRWAY DR, MARION, IL 62959-5841
- **Mailing address phone:** (618) 997-7820
- **Mailing address fax:** (618) 997-6721

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 7002900 | IL | Yes |

## Other

- **Enumeration date:** 02/24/2006
- **Last updated:** 10/05/2011