# TRACY WIMBUSH PAIN MANAGEMENT INC

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

## Provider details

- **NPI number:** 1629362579
- **Authorized official:** TRACY WIMBUSH M.D. (PRESIDENT)
- **Authorized official phone:** (412) 406-7765

## Contact information

- **Practice address:** 1350 OLD FREEPORT RD, SUITE 1B, PITTSBURGH, PA 15238-3122
- **Practice address phone:** (412) 406-7765
- **Practice address fax:** (412) 346-1288
- **Mailing address:** 1350 OLD FREEPORT RD, SUITE 1B, PITTSBURGH, PA 15238-3122
- **Mailing address phone:** (412) 406-7765
- **Mailing address fax:** (412) 346-1288

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208VP0000X | Pain Medicine Physician | — | NULL | Yes |
| 208VP0000X | Pain Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/07/2011
- **Last updated:** 07/06/2011