# SOUTHERN PAIN AND REHABILITATION INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Elite Pain and Spine
- **Organization subpart:** No

## Provider details

- **NPI number:** 1295377497
- **Authorized official:** JOHN T RUXER DO (PRESIDENT)
- **Authorized official phone:** (812) 639-9453

## Contact information

- **Practice address:** 5925 OLD HWY 60, STE D, PADUCAH, KY 42001
- **Practice address phone:** (270) 228-0118
- **Mailing address:** 5925 OLD HWY 60 WEST, SUITE D, PADUCAH, KY 42001-9647
- **Mailing address phone:** (270) 228-0118

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | — |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | — |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | — | NULL | Yes |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | — | — | Yes |
| 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