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Organization
SOUTHERN PAIN AND REHABILITATION INC
Active
Organization
SOUTHERN PAIN AND REHABILITATION INC
Active
Other names
Elite Pain and Spine
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN T RUXER DO (PRESIDENT)
(812) 639-9453
Entity
Organization
Contact information
Practice address
5925 OLD HWY 60, STE D, PADUCAH, KY 42001
(270) 228-0118
Mailing address
5925 OLD HWY 60 WEST, SUITE D, PADUCAH, KY 42001-9647
(270) 228-0118
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
—
NULL
208100000X
Physical Medicine & Rehabilitation Physician
—
—
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
—
NULL
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
NULL
363LF0000X
Family Nurse Practitioner
—
NULL
363LF0000X
Family Nurse Practitioner
—
—
363LG0600X
Gerontology Nurse Practitioner
—
NULL
363LG0600X
Gerontology Nurse Practitioner
—
—
Other
Enumeration date
10/09/2019
Last updated
09/17/2025
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