Organization
KENTUCKY PAIN PHYSICIANS, PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GAY RICHARDSON M.D. (CMO)
(770) 850-8464
Entity
Organization
Contact information
Practice address
286 US HIGHWAY 23 N, PRESTONSBURG, KY 41653-8732
(606) 874-0032
(606) 874-0064
Mailing address
286 US HIGHWAY 23 N, PRESTONSBURG, KY 41653-8732
(606) 874-0032
(606) 874-0064
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
—
KY
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
—
—
208VP0000X
Pain Medicine Physician
Primary
—
KY
208VP0014X
Interventional Pain Medicine Physician
—
KY
291U00000X
Clinical Medical Laboratory
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
363A00000X
Physician Assistant
—
—
363AM0700X
Medical Physician Assistant
—
—
363AS0400X
Surgical Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
363LA2200X
Adult Health Nurse Practitioner
—
—
363LX0106X
Occupational Health Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64126766
—
KY
05
—
7100033310
—
KY
05
—
7100239010
—
KY
05
—
7100240700
—
KY
05
—
7100240830
—
KY
05
—
7100242090
—
KY
05
—
7100265660
—
KY
Enumeration date
05/17/2006
Last updated
07/11/2016
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