Healthcare Provider Details

I. General information

NPI: 1134155864
Provider Name (Legal Business Name): RHODE ISLAND PAIN MEDICINE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

77 FRANKLIN ST SUITE B
WESTERLY RI
02891-3136
US

IV. Provider business mailing address

PO BOX 5568
WAKEFIELD RI
02880-5568
US

V. Phone/Fax

Practice location:
  • Phone: 401-596-2202
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number08358
License Number StateRI

VIII. Authorized Official

Name: EDWARD A KENT
Title or Position: PRESIDENT
Credential: MD
Phone: 401-596-2202