Organization
JERSEYVILLE PAIN MANAGEMENT CENTER, S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES A BRIGGS D.C. (PRESIDENT)
(618) 259-3321
Entity
Organization
Contact information
Practice address
1702 VAUGHN RD, WOOD RIVER, IL 62095-1898
(618) 259-3321
Mailing address
PO BOX 649, WOOD RIVER, IL 62095-0649
(618) 259-3321
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
038004303
IL
111N00000X
Chiropractor
038009545
IL
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
36048379
IL
208VP0014X
Interventional Pain Medicine Physician
36048379
IL
225100000X
Physical Therapist
70004750
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
038009545
—
IL
01
—
04232007
BCBS ILLINOIS
IL
01
—
210609
MEDICARE ILLINOIS
IL
01
—
224252
GHP
—
01
—
477779
HEALTHLINK
IL
01
—
5933000001
MEDICARE P-TAN
IL
Enumeration date
03/12/2012
Last updated
03/12/2012
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