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Organization

EAST LOUISVILLE INTERVENTIONAL PAIN SPECIALISTS, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. BILL HANEY MD (OWNER)
(502) 836-1171
Entity
Organization

Contact information

Practice address
4203 SPRINGHURST BLVD, SUITE 101, LOUISVILLE, KY 40241-6140
(502) 836-1171
Mailing address
4205 SPRINGHURST BLVD, SUITE 101, LOUISVILLE, KY 40241-6158
(502) 836-1171

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
363L00000X
Nurse Practitioner

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7100199990
KY
Enumeration date
04/10/2012
Last updated
01/03/2017
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