Organization
CHARLESTON PAIN MANAGEMENT CONSULTANTS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. OLIVIA GARTON (ADMINISTRATOR)
(304) 925-9300
Entity
Organization
Contact information
Practice address
2335 CHESTERFIELD AVE STE 302, CHARLESTON, WV 25304-1066
(304) 925-3535
(304) 925-3662
Mailing address
2335 CHESTERFIELD AVE STE 302, CHARLESTON, WV 25304-1066
(304) 925-3535
(304) 925-3662
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
—
261QP3300X
Pain Clinic/Center
12738
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000734070
MOUNTAINSTATE BCBS
—
05
—
0063877000
—
WV
Enumeration date
02/19/2008
Last updated
01/12/2023
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