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General NPI Number Information
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NPI Number | 1265909980
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Entity Type | Organization
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Legal Business Name | KINSTON REGIONAL PAIN CENTER LLC
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Dates
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Enumeration Date | 10/31/2018
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Last Update Date | 11/23/2020
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Provider Practice Location Address
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Address Line | 2100 PRESBYTERIAN LN
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City | KINSTON
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State | NC
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Zip | 28501-2266
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Country | US
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Telephone | 814-720-6877
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Fax |
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Provider Business Mailing Address
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Address Line | 2100 PRESBYTERIAN LN
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City | KINSTON
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State | NC
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Zip | 28501-2266
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | HEATH A FALLIN
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Credential | MD
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Telephone | 252-208-7784
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number |
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License Number State |
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