Healthcare Provider Details

I. General information

NPI: 1467744920
Provider Name (Legal Business Name): PAIN CARE SPECIALISTS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2011
Last Update Date: 04/06/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6397 EMERALD PKWY
DUBLIN OH
43016-2200
US

IV. Provider business mailing address

6397 EMERALD PKWY SUITE 100
DUBLIN OH
43016-2200
US

V. Phone/Fax

Practice location:
  • Phone: 614-777-5700
  • Fax: 614-777-5777
Mailing address:
  • Phone: 614-777-5700
  • Fax: 614-777-5777

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: MS. CONSTANCE REDMAN
Title or Position: PRACTICE MANAGER
Credential:
Phone: 614-777-5860