Organization
ADVANCED PAIN CONTROL CENTER, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RONNY KAFILUDDI M.D., PHD (OWNER)
(563) 359-3949
Entity
Organization
Contact information
Practice address
4550 E 53RD STREET, SUITE 100, DAVENPORT, IA 52807-2710
(563) 332-2152
Mailing address
1970 E 53RD ST, DAVENPORT, IA 52807-2710
(563) 359-3949
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0464404
—
IA
Enumeration date
03/24/2006
Last updated
07/17/2008
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