# ATLANTIC COAST PAIN SPECIALISTS, INC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1629460381
- **Authorized official:** RICHARD BLAKE KLINE MD (OWNER)
- **Authorized official phone:** (843) 438-8470

## Contact information

- **Practice address:** 2767 CULTRA RD, CONWAY, SC 29526-3716
- **Practice address phone:** (843) 438-8470
- **Practice address fax:** (843) 438-8480
- **Mailing address:** 2767 CULTRA RD, CONWAY, SC 29526-3716
- **Mailing address phone:** (843) 438-8470
- **Mailing address fax:** (843) 438-8480

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | — | NULL | — |
| 207L00000X | Anesthesiology Physician | — | — | — |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | 20364 | SC | — |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | NULL | Yes |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | — | Yes |
| 207QA0505X | Adult Medicine Physician | — | NULL | — |
| 207QA0505X | Adult Medicine Physician | — | — | — |
| 225100000X | Physical Therapist | — | NULL | — |
| 225100000X | Physical Therapist | — | — | — |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 363AM0700X | Medical Physician Assistant | — | NULL | — |
| 363AM0700X | Medical Physician Assistant | — | — | — |

## Other

- **Enumeration date:** 03/04/2015
- **Last updated:** 04/20/2022