# PROFESSIONAL PAIN MANAGEMENT, S.C.

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

## Provider details

- **NPI number:** 1790964435
- **Authorized official:** DR. ROBERT PURTOCK M.D. (PRESIDENT)
- **Authorized official phone:** (262) 787-4026

## Contact information

- **Practice address:** 225 S EXECUTIVE DR, BROOKFIELD, WI 53005-4257
- **Practice address phone:** (262) 787-4026
- **Practice address fax:** (262) 782-6040
- **Mailing address:** 225 S EXECUTIVE DR, BROOKFIELD, WI 53005-4257
- **Mailing address phone:** (262) 787-4026
- **Mailing address fax:** (262) 782-6040

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | 23846-20 | WI | — |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | 23846-20 | WI | Yes |
| 208VP0014X | Interventional Pain Medicine Physician | 23846 | WI | — |

## Other

- **Enumeration date:** 10/30/2007
- **Last updated:** 10/30/2007