Organization
MIDWEST PAIN CLINIC INTERVENTIONAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL C MADISON M.D. (OWNER)
(219) 872-9158
Entity
Organization
Contact information
Practice address
350 COMMERCE SQ, MICHIGAN CITY, IN 46360-3376
(219) 872-9158
(219) 873-9196
Mailing address
350 COMMERCE SQ, MICHIGAN CITY, IN 46360-3376
(219) 872-9158
(219) 873-9196
Taxonomy
Speciality
Code
Description
License number
State
261QP3300X
Pain Clinic/Center
Primary
01031628A
IN
Other
Enumeration date
09/24/2013
Last updated
02/17/2017
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