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General NPI Number Information
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NPI Number | 1346504792
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Entity Type | Organization
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Legal Business Name | PAIN MANAGEMENT ASSOCIATES
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Dates
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Enumeration Date | 06/30/2012
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Last Update Date | 06/30/2012
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Provider Practice Location Address
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Address Line | 105 VINECREST CT SUITE 605
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City | GREENWOOD
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State | SC
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Zip | 29646-8031
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Country | US
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Telephone | 864-953-9885
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Fax | 863-953-9883
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Provider Business Mailing Address
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Address Line | PO BOX 484
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City | EASLEY
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State | SC
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Zip | 29641-0484
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Country | US
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Telephone | 864-855-1622
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Fax | 864-855-1323
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DANIEL A. MCCOLLUM
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Credential | D..
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Telephone | 864-855-1633
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number |
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License Number State |
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