# PROFESSIONAL PHYSICIAN PAIN SERVICES, LLC

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

## Provider details

- **NPI number:** 1871729723
- **Authorized official:** DEBORAH NEAL (COORDINATOR)
- **Authorized official phone:** (405) 947-5557

## Contact information

- **Practice address:** 114 PIPER HILL DR, SUITE 103, SAINT PETERS, MO 63376-1661
- **Practice address phone:** (636) 442-5035
- **Practice address fax:** (636) 442-5036
- **Mailing address:** 4400 WILL ROGERS PKWY, SUITE 105, OKLAHOMA CITY, OK 73108-1837
- **Mailing address phone:** (405) 947-5557
- **Mailing address fax:** (405) 948-6507

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | 2004009978 | MO | Yes |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | 2006018031 | MO | — |

## Other

- **Enumeration date:** 06/05/2009
- **Last updated:** 06/30/2009