Healthcare Provider Details

I. General information

NPI: 1760779664
Provider Name (Legal Business Name): BKC PAIN SPECIALISTS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2011
Last Update Date: 06/30/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1065 DELAWARE AVE
MARION OH
43302-6415
US

IV. Provider business mailing address

PO BOX 1573
MARION OH
43301-1573
US

V. Phone/Fax

Practice location:
  • Phone: 740-387-7246
  • Fax: 740-387-7244
Mailing address:
  • Phone: 740-387-7246
  • Fax: 740-387-7244

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number35.081178B
License Number StateOH

VIII. Authorized Official

Name: DR. NIKESH BATRA
Title or Position: PRINCIPAL
Credential: MD
Phone: 740-387-7246