Healthcare Provider Details

I. General information

NPI: 1659312007
Provider Name (Legal Business Name): PAIN CONSULTANTS OF ALABAMA,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2006
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4105 HOSPITAL ST SUITE 112B
PASCAGOULA MS
39581-5312
US

IV. Provider business mailing address

4960 SW 72ND AVE STE 405
MIAMI FL
33155-5506
US

V. Phone/Fax

Practice location:
  • Phone: 228-938-0700
  • Fax: 228-938-0705
Mailing address:
  • Phone: 469-458-9222
  • Fax: 443-595-6960

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number00015545
License Number StateAL

VIII. Authorized Official

Name: HUNTINGTON T HAPWORTH
Title or Position: DIRECTOR
Credential:
Phone: 228-938-0699