Organization
PAIN MANAGEMENT PSYCHOLOGY SERVICES, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIMOTHY NORRIS WEBSTER PH.D. (PRESIDENT)
(336) 770-6451
Entity
Organization
Contact information
Practice address
160 KIMEL FOREST DR., STE. 100, WINSTON-SALEM, NC 27103-6084
(336) 770-6451
(336) 714-6475
Mailing address
160 KIMEL FOREST DR., STE. 100, WINSTON-SALEM, NC 27103-6084
(336) 770-6451
(336) 714-6475
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
0388
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6006753
—
NC
01
—
616591400
DOL/OWCP (DEPARTMENT OF LABOR OFFICE OF WORKERS COMPENSATION PROGRAMS)
—
Enumeration date
03/02/2009
Last updated
10/18/2013
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