Organization
LAKE OF THE OZARKS PAIN MANAGEMENT SERVICES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALAN W MEAD MD (OWNER)
(573) 302-1661
Entity
Organization
Contact information
Practice address
54 HOSPITAL DR, OSAGE BEACH, MO 65065-3050
(573) 302-1661
Mailing address
5151 OSAGE BEACH PKWY STE F, PO BOX 840, OSAGE BEACH, MO 65065-3285
(573) 302-1661
(573) 302-1719
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
508901402
—
MO
Enumeration date
10/04/2006
Last updated
05/25/2012
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