Healthcare Provider Details

I. General information

NPI: 1558817932
Provider Name (Legal Business Name): COMPREHENSIVE PAIN CONSULTANTS OF THE CAROLINAS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2016
Last Update Date: 01/10/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31 CALIFORNIA AVE
MARION NC
28752-9389
US

IV. Provider business mailing address

310 OVERLOOK RD STE B
ASHEVILLE NC
28803-3319
US

V. Phone/Fax

Practice location:
  • Phone: 828-559-3399
  • Fax: 828-687-7858
Mailing address:
  • Phone: 828-483-5788
  • Fax: 828-687-7858

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number StateNC
# 3
Primary TaxonomyY
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number
License Number StateNC

VIII. Authorized Official

Name: ALLISON WILSON
Title or Position: OFFICE MANAGER
Credential:
Phone: 828-483-5788