Organization
PAINSTOP SPINE CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. STACEY M TSANG (GENERAL MANAGER)
(626) 512-6348
Entity
Organization
Contact information
Practice address
3003 SHORTCUT RD, PASCAGOULA, MS 39567-1810
(228) 273-4096
(228) 594-1765
Mailing address
PO BOX 4594, BILOXI, MS 39535-4594
(228) 273-4096
(228) 594-1765
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
208VP0014X
Interventional Pain Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00057070
—
MS
01
—
30270G0134
MCR PTAN GROUP
MS
01
—
DT9919
RAILROAD MEDICARE, GROUP PTAN
MS
Enumeration date
01/13/2011
Last updated
01/07/2020
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