Healthcare Provider Details

I. General information

NPI: 1447671672
Provider Name (Legal Business Name): PAIN & REHABILITATION CONSULTANTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2013
Last Update Date: 11/29/2023
Certification Date: 11/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44 HUGHES RD. SUITE 2500
MADISON AL
35758
US

IV. Provider business mailing address

44 HUGHES RD. SUITE 2500
MADISON AL
35758
US

V. Phone/Fax

Practice location:
  • Phone: 256-464-7855
  • Fax: 855-301-8314
Mailing address:
  • Phone: 256-464-7855
  • Fax: 855-301-8314

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number290006
License Number StateAL

VIII. Authorized Official

Name: NORMAN EUGENE MCCOOMER
Title or Position: CEO/OWNER
Credential: M.D
Phone: 256-464-7855