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General NPI Number Information
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NPI Number | 1487024527
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Entity Type | Organization
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Legal Business Name | DPI PAIN MANAGEMENT LLC
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Dates
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Enumeration Date | 10/01/2015
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Last Update Date | 03/22/2016
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Provider Practice Location Address
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Address Line | 4727 W PARK DR SUITE B
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City | ZACHARY
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State | LA
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Zip | 70791-4090
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Country | US
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Telephone | 225-923-0030
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Fax | 225-923-0060
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Provider Business Mailing Address
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Address Line | 8946 INTERLINE AVE STE C
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City | BATON ROUGE
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State | LA
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Zip | 70809-1913
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Country | US
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Telephone | 225-923-0030
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Fax | 225-923-0060
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Authorized Official
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Title or Position | OWNER
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Name | MR. JOHN MICHAEL SIKES
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Credential | CRNA
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Telephone | 225-923-0030
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number |
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License Number State | LA
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