Healthcare Provider Details

I. General information

NPI: 1356653059
Provider Name (Legal Business Name): AUSTIN PAIN CONSULTANTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2010
Last Update Date: 10/12/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

860 MONTCLAIR RD 955
BIRMINGHAM AL
35213-1923
US

IV. Provider business mailing address

860 MONTCLAIR RD 955
BIRMINGHAM AL
35213-1923
US

V. Phone/Fax

Practice location:
  • Phone: 205-332-3160
  • Fax: 866-702-0880
Mailing address:
  • Phone: 205-332-3160
  • Fax: 866-702-0880

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number27611
License Number StateAL

VIII. Authorized Official

Name: CHAD E AUSTIN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 205-332-3160