Healthcare Provider Details

I. General information

NPI: 1902231178
Provider Name (Legal Business Name): INTERVENTIONAL PAIN MANAGEMENT ASSOCIATES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2013
Last Update Date: 01/30/2026
Certification Date: 01/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17 MEDICAL PLZ
MOUNTAIN HOME AR
72653-2918
US

IV. Provider business mailing address

250 BUCHER DR
MOUNTAIN HOME AR
72653-3400
US

V. Phone/Fax

Practice location:
  • Phone: 870-425-6235
  • Fax: 870-424-3774
Mailing address:
  • Phone: 501-247-0358
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name: DR. MATTHEW JAMES MCNELLEY
Title or Position: MANAGING PARTNER
Credential: M.D.
Phone: 501-247-0358