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Organization

PAIN MANAGEMENT & ANESTHESIOLOGY ASSOCIATES LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. CHARLES DAVID HORD M.D. (PARTNER)
(704) 377-1647
Entity
Organization

Contact information

Practice address
2825 RANDOLPH RD, CHARLOTTE, NC 28211-1075
(704) 377-1647
(559) 354-4235
Mailing address
PO BOX 5615, FRESNO, CA 93755-5615
(800) 436-1018
(559) 354-4235

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
NC
207LP2900X
Pain Medicine (Anesthesiology) Physician
NC
367500000X
Certified Registered Nurse Anesthetist
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0219C
BLUE CROSS BLUE SHIELD
NC
05
8000323
NC
05
89014FK
NC
01
CK4257
RAILROAD MEDICARE
NC
Enumeration date
01/31/2006
Last updated
01/19/2010
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