Healthcare Provider Details

I. General information

NPI: 1093709958
Provider Name (Legal Business Name): SOUTHERN PAIN ASSOCIATES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/07/2005
Last Update Date: 06/30/2025
Certification Date: 06/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 14TH ST
MERIDIAN MS
39301-4458
US

IV. Provider business mailing address

PO BOX 649105
DALLAS TX
75264
US

V. Phone/Fax

Practice location:
  • Phone: 601-482-9224
  • Fax: 601-482-9223
Mailing address:
  • Phone: 903-571-3844
  • Fax: 855-343-5763

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ERIC PEARSON
Title or Position: PRESIDENT
Credential: MD
Phone: 601-482-9224