Organization
PAIN CLINIC ASSOCIATES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAY SAUNDERS (PRACTICE ADMINISTRATOR)
(901) 507-1595
Entity
Organization
Contact information
Practice address
7600 AIRWAYS BLVD STE A, SOUTHAVEN, MS 38671-5138
(901) 747-0040
(901) 747-0038
Mailing address
PO BOX 931320, ATLANTA, GA 31193-1320
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
—
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
2084N0400X
Neurology Physician
—
—
208VP0014X
Interventional Pain Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1306496567
NPI
MS
Enumeration date
09/18/2019
Last updated
03/15/2024
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