Healthcare Provider Details

I. General information

NPI: 1225673874
Provider Name (Legal Business Name): PAIN AT FHO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2019
Last Update Date: 11/11/2025
Certification Date: 11/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 W CENTRAL AVE STE 206
EL DORADO KS
67042-2186
US

IV. Provider business mailing address

822 N ANDOVER RD
ANDOVER KS
67002-9527
US

V. Phone/Fax

Practice location:
  • Phone: 316-452-5113
  • Fax: 316-452-5171
Mailing address:
  • Phone: 316-247-5499
  • Fax: 316-351-5965

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: CINDY CLOUGH
Title or Position: PRACTICE MANAGER
Credential:
Phone: 316-247-5499