Organization
ADVANCED INTERVENTIONAL PAIN SURGERY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACOB EDATHARA ABRAHAM MD (PRESIDENT)
(501) 655-1335
Entity
Organization
Contact information
Practice address
1717 MALVERN AVENUE, HOT SPRINGS, AR 71913-6442
(501) 321-4772
(501) 321-2945
Mailing address
1717 MALVERN AVENUE, HOT SPRINGS, AR 71913
(501) 321-4772
(501) 321-2945
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
10/04/2016
Last updated
10/04/2016
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