Healthcare Provider Details

I. General information

NPI: 1346408838
Provider Name (Legal Business Name): CENTER FOR PAIN RELIEF INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/30/2008
Last Update Date: 10/14/2025
Certification Date: 10/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 PEYTON WAY STE 100
CHARLESTON WV
25309-8545
US

IV. Provider business mailing address

400 COURT ST STE 100
CHARLESTON WV
25301-1652
US

V. Phone/Fax

Practice location:
  • Phone: 304-720-6747
  • Fax: 304-720-6749
Mailing address:
  • Phone: 304-347-6120
  • Fax: 304-347-6126

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number17647
License Number StateWV
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number17647
License Number StateWV
# 4
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number17647
License Number StateWV
# 5
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number17647
License Number StateWV

VIII. Authorized Official

Name: TIMOTHY RAY DEER
Title or Position: MD, OWNER, PRESIDENT & CEO
Credential: MD
Phone: 304-347-6120