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General NPI Number Information
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NPI Number | 1639818040
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Entity Type | Organization
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Legal Business Name | PAUSE PAIN AND WELLNESS CENTER LLC
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Dates
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Enumeration Date | 06/02/2022
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Last Update Date | 12/06/2024
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Provider Practice Location Address
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Address Line | 101 RICKY BRITT SR BLVD. SUITE 2
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City | OXFORD
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State | MS
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Zip | 38655
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Country | US
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Telephone | 866-212-0685
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Fax |
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Provider Business Mailing Address
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Address Line | 101 RICKY D BRITT SR BLVD STE 1A
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City | OXFORD
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State | MS
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Zip | 38655-9111
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Country | US
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Telephone | 833-940-5060
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. ROBERT P GAMMONS
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Credential |
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Telephone | 321-286-7916
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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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