Organization
ELITE PAIN MANAGEMENT, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID M. TONKIN MD (DOCTOR)
(417) 720-4991
Entity
Organization
Contact information
Practice address
1230 E KINGSLEY ST STE C, SPRINGFIELD, MO 65804-7231
(417) 553-1080
(888) 472-5145
Mailing address
1230 E KINGSLEY ST STE C, SPRINGFIELD, MO 65804-7231
(417) 553-1080
(888) 472-5145
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2007017247
MISSOURI MEDICAL LICENSE
MO
01
—
7422650001
NATIONAL SUPPLIER CLEARING HOUSE MEDICARE DMEPOS
MO
Enumeration date
06/15/2015
Last updated
10/09/2023
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