# INDIANA INTERVENTIONAL PAIN, LLC

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

## Provider details

- **NPI number:** 1982648762
- **Authorized official:** JOHN B SWOFFORD D.O. (PRESIDENT-OWNER)
- **Authorized official phone:** (317) 567-2180

## Contact information

- **Practice address:** 5445 E 16TH ST, INDIANAPOLIS, IN 46218-4869
- **Practice address phone:** (317) 355-4358
- **Practice address fax:** (317) 567-2191
- **Mailing address:** PO BOX 3056, INDIANAPOLIS, IN 46206-3056
- **Mailing address phone:** (317) 567-2180
- **Mailing address fax:** (317) 567-2191

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | IN | Yes |
| 208VP0000X | Pain Medicine Physician | — | IN | — |

## Other

- **Enumeration date:** 06/15/2006
- **Last updated:** 11/25/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000000373172 | ANTHEM | IN |
| 05 | — | 200530430 | — | IN |
| 01 | — | DE7729 | RAILROAD MEDICARE | IN |