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Organization
CLAY PAIN CENTER PHYSICIANS LLC
Active
Organization
CLAY PAIN CENTER PHYSICIANS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARL R. NOBACK MD (MEMBER)
(941) 360-1566
Entity
Organization
Contact information
Practice address
1564 KINGSLEY AVE, ORANGE PARK, FL 32073-4511
(904) 264-0400
Mailing address
PO BOX 864483, ORLANDO, FL 32886-4486
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
—
—
208VP0014X
Interventional Pain Medicine Physician
—
—
Other
Enumeration date
06/22/2009
Last updated
06/24/2009
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