# PAIN MANAGEMENT & SURGERY CENTER OF SOUTHERN INDIANA

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

## Provider details

- **NPI number:** 1538154604
- **Authorized official:** KAMAL KUMAR TIWARI MD (PRESIDENT)
- **Authorized official phone:** (812) 824-5688

## Contact information

- **Practice address:** 2920 MCINTYRE DR, SUITE 150, BLOOMINGTON, IN 47403-4221
- **Practice address phone:** (812) 333-7246
- **Practice address fax:** (812) 333-4471
- **Mailing address:** PO BOX 5635, ATTN MARIA MITCHELL, BLOOMINGTON, IN 47407-5635
- **Mailing address phone:** (812) 824-5688
- **Mailing address fax:** (812) 824-5692

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 61100223B | IN | Yes |

## Other

- **Enumeration date:** 09/15/2005
- **Last updated:** 08/22/2020