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General NPI Number Information
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NPI Number | 1346589736
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Entity Type | Organization
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Legal Business Name | INTERVENTIONAL PAIN SOLUTIONS
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Dates
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Enumeration Date | 02/05/2013
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Last Update Date | 02/05/2013
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Provider Practice Location Address
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Address Line | 1430 GADSDEN HWY SUITE 116 - 150
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City | BIRMINGHAM
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State | AL
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Zip | 35235-3126
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Country | US
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Telephone | 205-834-4082
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Fax |
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Provider Business Mailing Address
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Address Line | 1430 GADSDEN HWY SUITE 116 - 150
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City | BIRMINGHAM
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State | AL
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Zip | 35235-3126
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Country | US
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Telephone | 205-834-4082
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. RICHARD H MAUGHON
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Credential | MD
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Telephone | 205-834-4082
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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 | 21909
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License Number State | AL
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