Organization
828 WALK IN CLINIC
Active
Parent organization
PAINSTOP SPINE CLINIC, LLC
Other names
Painstop Spine Clinic, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
PAINSTOP SPINE CLINIC, LLC
Authorized official
STACEY M TSANG (GENERAL MANAGER)
(228) 273-4096
Entity
Organization
Contact information
Practice address
12207 HWY 49, SUITE 40, GULFPORT, MS 39503
(228) 832-8872
(866) 809-7246
Mailing address
PO BOX 4594, BILOXI, MS 39535-4594
(228) 273-4096
(866) 809-7246
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
14282
MS
363L00000X
Nurse Practitioner
R791344
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00114733
—
MS
05
—
04078379
—
MS
Enumeration date
11/28/2011
Last updated
11/28/2011
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