Organization
INTERVENTIONAL PAIN CENTER PLLC
Active
Other names
Fayetteville Pain Center, PLLC
Organization subpart
No
Provider details
NPI number
Authorized official
SHANEKA TINCH (RCM MANAGER)
(469) 458-9222
Entity
Organization
Contact information
Practice address
2153 VALLEYGATE DR, SUITE 102, FAYETTEVILLE, NC 28304-3681
(910) 321-7246
(910) 321-7245
Mailing address
PO BOX 931038, ATLANTA, GA 31193-1038
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
200100673
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
89014Y4
—
NC
Enumeration date
01/03/2007
Last updated
12/08/2025
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