Organization
PAIN MANAGEMENT CENTER OF SOUTHERN INDIANA, INC.
Active
Organization
PAIN MANAGEMENT CENTER OF SOUTHERN INDIANA, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAMAL KUMAR TIWARI MD (PRESIDENT)
(812) 333-7246
Entity
Organization
Contact information
Practice address
2920 MCINTYRE DR, SUITE 150, BLOOMINGTON, IN 47403-4221
(812) 333-7246
(812) 333-4471
Mailing address
PO BOX 5635, BLOOMINGTON, IN 47407-5635
(812) 337-5003
(812) 337-5010
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
50003765A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100389270
—
IN
Enumeration date
09/15/2005
Last updated
06/15/2009
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