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General NPI Number Information
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NPI Number | 1679367155
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Entity Type | Organization
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Legal Business Name | INTERVENTIONAL PAIN SPECIALISTS, LLC
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Dates
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Enumeration Date | 04/08/2025
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Last Update Date | 04/23/2025
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Provider Practice Location Address
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Address Line | 1101 S COLLEGE RD STE 200
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City | LAFAYETTE
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State | LA
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Zip | 70503-3038
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Country | US
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Telephone | 337-362-8101
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Fax | 337-761-1616
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Provider Business Mailing Address
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Address Line | PO BOX 69
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City | OPELOUSAS
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State | LA
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Zip | 70571-0069
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Country | US
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Telephone | 337-284-3200
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Fax | 800-207-6956
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Authorized Official
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Title or Position | OWNER
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Name | DR. ALBERT J GROS
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Credential | MD
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Telephone | 337-284-3200
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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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Taxonomy #2
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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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