Organization
CAROLINA PAIN SPECIALISTS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT DENNIS CHAPPLE (PRACTICE MANAGER)
(803) 739-6628
Entity
Organization
Contact information
Practice address
421 HULON LN, WEST COLUMBIA, SC 29169-4832
(803) 739-6628
(803) 739-5766
Mailing address
421 HULON LN, WEST COLUMBIA, SC 29169-4832
(803) 739-6628
(803) 739-5766
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
14490
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4646343
AETNA
SC
01
—
CN1741
RAILROAD MEDICARE
SC
05
—
GP1633
—
SC
Enumeration date
09/04/2007
Last updated
11/27/2007
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