Healthcare Provider Details

I. General information

NPI: 1497322093
Provider Name (Legal Business Name): INTEGRATED PAIN SOLUTIONS INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2021
Last Update Date: 04/11/2025
Certification Date: 04/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1117 E HOME RD
SPRINGFIELD OH
45503-2725
US

IV. Provider business mailing address

1210 GEMINI PL STE 300
COLUMBUS OH
43240-6112
US

V. Phone/Fax

Practice location:
  • Phone: 614-383-6450
  • Fax:
Mailing address:
  • Phone: 614-383-6450
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: EDWARD J KOWLOWITZ
Title or Position: OWNER
Credential: MD
Phone: 317-706-7246