Healthcare Provider Details

I. General information

NPI: 1609796770
Provider Name (Legal Business Name): ADVANCED PAIN CARE CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6426 HIGHWAY 51 N
HORN LAKE MS
38637-2474
US

IV. Provider business mailing address

6426 HIGHWAY 51 N STE B
HORN LAKE MS
38637-2474
US

V. Phone/Fax

Practice location:
  • Phone: 662-440-7246
  • Fax: 662-439-7246
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MAHENDRA R. SANAPATI
Title or Position: PRESIDENT
Credential:
Phone: 812-477-7246