Organization
ADVANCED PAIN MEDICINE, PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAROJ B. DUBAL M.D. (PRESIDENT)
(859) 271-3114
Entity
Organization
Contact information
Practice address
101 PROSPEROUS PL, SUITE 300, LEXINGTON, KY 40509-1882
(859) 271-3114
(859) 271-0220
Mailing address
PO BOX 23955, LEXINGTON, KY 40523-3955
(859) 271-3114
(859) 271-0220
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
208VP0000X
Pain Medicine Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363AM0700X
Medical Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000108103
ANTHEM B/C & B/S PIN
KY
01
—
050076771
RAILROAD MEDICARE
KY
01
—
1168975
CHA HEALTH PIN
KY
05
—
65906067
—
KY
01
—
C15401
BLUEGRASS FAMILY HEALTH
KY
Enumeration date
07/12/2005
Last updated
10/02/2014
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