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General NPI Number Information
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NPI Number | 1558421560
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Entity Type | Organization
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Legal Business Name | INTEGRATIVE PAIN MANAGEMENT SC
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Dates
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Enumeration Date | 12/11/2006
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Last Update Date | 09/23/2024
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Provider Practice Location Address
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Address Line | 555 S WASHBURN ST
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City | OSHKOSH
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State | WI
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Zip | 54904-6710
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Country | US
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Telephone | 920-230-7246
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Fax |
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Provider Business Mailing Address
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Address Line | 555 S WASHBURN ST
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City | OSHKOSH
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State | WI
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Zip | 54904-6710
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Country | US
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Telephone | 920-230-7246
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOHN JOSEPH
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Credential | M.D.
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Telephone | 920-230-7246
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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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