# GULF COAST PAIN CONSULTANTS LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Clearway Pain Solutions Institute
- **Organization subpart:** No

## Provider details

- **NPI number:** 1891354007
- **Authorized official:** KACEY A MONTGOMERY MD (MEDICAL DIRECTOR)
- **Authorized official phone:** (850) 791-6895

## Contact information

- **Practice address:** 2507 HARRISON AVE UNIT 200, PANAMA CITY, FL 32405-4447
- **Practice address phone:** (855) 527-7246
- **Practice address fax:** (866) 229-5063
- **Mailing address:** 201 DEFENSE HWY STE 205, ANNAPOLIS, MD 21401-7096
- **Mailing address phone:** (855) 527-7246
- **Mailing address fax:** (833) 810-1165

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | NULL | — |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | — | — |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | — |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | — |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | — | NULL | — |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | — | — | — |
| 208VP0000X | Pain Medicine Physician | — | NULL | — |
| 208VP0000X | Pain Medicine Physician | — | — | — |
| 208VP0014X | Interventional Pain Medicine Physician | — | NULL | — |
| 208VP0014X | Interventional Pain Medicine Physician | — | — | — |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | Yes |

## Other

- **Enumeration date:** 06/11/2019
- **Last updated:** 01/27/2025