Organization
COMPREHENSIVE PAIN MANAGEMENT,INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW RICHARD JACONETTE MD (PRESIDENT)
(907) 677-7440
Entity
Organization
Contact information
Practice address
851 WESTPOINT DR, SUITE 203, WASILLA, AK 99654-7142
(907) 373-7934
(907) 373-7935
Mailing address
PO BOX 210850, ANCHORAGE, AK 99521-0850
(907) 677-6900
(907) 677-6999
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
5328
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MDG171
—
AK
Enumeration date
04/10/2007
Last updated
09/12/2009
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