Organization
PAIN RELIEF CENTERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT KLICKOVICH MD (OWNER)
(502) 430-6223
Entity
Organization
Contact information
Practice address
5129 DIXIE HWY STE 201, LOUISVILLE, KY 40216-1727
(502) 430-6223
(502) 792-7291
Mailing address
5129 DIXIE HWY STE 201, LOUISVILLE, KY 40216-1727
(502) 430-6223
(502) 369-5229
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
208VP0000X
Pain Medicine Physician
—
—
208VP0014X
Interventional Pain Medicine Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001189445
ANTHEM
KY
05
—
300013523
—
IN
05
—
7100546550
—
KY
05
—
7100999960
—
KY
Enumeration date
02/15/2018
Last updated
02/18/2025
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