Organization
COMMONWEALTH PAIN SPECIALISTS, LLC
Active
Other names
Commonwealth Pain Specialists
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEPHEN P LONG MD (MEDICAL DIRECTOR/PARTNER)
(804) 288-7246
Entity
Organization
Contact information
Practice address
1501 MAPLE AVENUE, SUITE 301, RICHMOND, VA 23229
(804) 288-7246
(804) 288-7245
Mailing address
PO BOX 8310, ROANOKE, VA 24014-0310
(540) 345-3556
(540) 342-2193
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
0101043055
VA
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
208VP0000X
Pain Medicine Physician
—
—
208VP0014X
Interventional Pain Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
431692
ANTHEM
VA
01
—
CH0711
MEDICARE RAILROAD
VA
Enumeration date
09/27/2007
Last updated
01/31/2020
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