Organization
CONSULTANTS IN PAIN MEDICINE,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS E RUNYAN M.D. (OWNER)
(912) 466-9111
Entity
Organization
Contact information
Practice address
303 HARRIS INDUSTRIAL BLVD, VIDALIA, GA 30474-8853
(912) 537-4414
(912) 537-4437
Mailing address
3221 GLYNN AVE, BRUNSWICK, GA 31520-4851
(912) 466-9111
(912) 466-0366
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6400190001
DME PTAN
GA
Enumeration date
09/22/2010
Last updated
04/18/2011
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