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Organization

COMPREHENSIVE PAIN CENTER OF MISSISSIPPI

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LEONEL KEVIN VANCE M.D. (OWNER)
(769) 300-0730
Entity
Organization

Contact information

Practice address
129 FOUNTAINS BLVD, MADISON, MS 39110
(769) 300-0730
(601) 949-2782
Mailing address
129 FOUNTAINS BLVD, MADISON, MS 39110
(601) 949-9994

Taxonomy

Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
16855
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2389791
MS
Enumeration date
08/27/2008
Last updated
03/05/2025
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