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Organization
COMPREHENSIVE PAIN REHAB OF SOUTHERN INDIANA LLC
Active
Organization
COMPREHENSIVE PAIN REHAB OF SOUTHERN INDIANA LLC
Active
Other names
Pain Management Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
DERK FRASIER (OWNER)
(812) 333-7246
Entity
Organization
Contact information
Practice address
8802 S. MADISON AVENUE, SUITE D, INDIANAPOLIS, IN 46227-6400
(812) 333-7246
(812) 889-6720
Mailing address
8802 S. MADISON AVENUE, SUITE D, INDIANAPOLIS, IN 46227-6400
(812) 333-7246
(812) 889-6720
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
IN
208VP0000X
Pain Medicine Physician
Primary
—
IN
363L00000X
Nurse Practitioner
—
IN
363LF0000X
Family Nurse Practitioner
—
IN
Other
Enumeration date
09/08/2010
Last updated
09/08/2010
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