# MANOOCHEHR MAZLOOMDOOST PSC

> 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
- **Other names:** Pain Management Medicine, Wellward Regenerative Medicine
- **Organization subpart:** No

## Provider details

- **NPI number:** 1770555492
- **Authorized official:** DR. DANESH MAZLOOMDOOST MD (MEDICAL DIRECTOR)
- **Authorized official phone:** (859) 275-4878

## Contact information

- **Practice address:** 101 N EAGLE CREEK DR \# 120, LEXINGTON, KY 40509-1806
- **Practice address phone:** (859) 275-4878
- **Practice address fax:** (859) 276-5400
- **Mailing address:** 101 N EAGLE CREEK DR \# 120, LEXINGTON, KY 40509-1806
- **Mailing address phone:** (859) 275-4878
- **Mailing address fax:** (859) 276-5400

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 104100000X | Social Worker | — | NULL | — |
| 104100000X | Social Worker | — | — | — |
| 1041C0700X | Clinical Social Worker | — | — | — |
| 111N00000X | Chiropractor | — | NULL | — |
| 111N00000X | Chiropractor | — | — | — |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | NULL | Yes |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | — | Yes |
| 2084P2900X | Pain Medicine (Psychiatry & Neurology) Physician | — | NULL | — |
| 2084P2900X | Pain Medicine (Psychiatry & Neurology) Physician | — | — | — |
| 225100000X | Physical Therapist | — | NULL | — |
| 225100000X | Physical Therapist | — | — | — |
| 363A00000X | Physician Assistant | — | NULL | — |
| 363A00000X | Physician Assistant | — | — | — |

## Other

- **Enumeration date:** 02/06/2006
- **Last updated:** 07/08/2026