Organization
IC PAIN, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIP CARDELL NEWELL DO (OWNER/DO)
(402) 547-9405
Entity
Organization
Contact information
Practice address
NORTHWEST MEDICAL CENTER, 2210 BARRON RD, SUITE 203, POPLAR BLUFF, MD 63901
(573) 776-0157
(573) 776-6504
Mailing address
NORTHWEST MEDICAL CENTER, 2210 BARRON RD, SUITE 203, POPLAR BLUFF, MD 63901
(573) 776-0157
(573) 776-6504
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Enumeration date
12/16/2018
Last updated
12/16/2018
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