Healthcare Provider Details

I. General information

NPI: 1811928724
Provider Name (Legal Business Name): PAIN MANAGEMENT CENTER OF NORTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2006
Last Update Date: 01/06/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2089 SOUTHRIDGE DR
TUPELO MS
38801-6478
US

IV. Provider business mailing address

PO BOX 11407
BIRMINGHAM AL
35246-1218
US

V. Phone/Fax

Practice location:
  • Phone: 662-407-0801
  • Fax: 662-407-0807
Mailing address:
  • Phone: 800-897-6169
  • Fax: 800-897-6170

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP3300X
TaxonomyPain Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. GEORGE MONROE HAMMITT III
Title or Position: OWNER
Credential: M.D.
Phone: 662-407-0801