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General NPI Number Information
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NPI Number | 1780743732
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Entity Type | Organization
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Legal Business Name | INTERVENTIONAL PAIN CONSULTANTS, PA
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Dates
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Enumeration Date | 12/06/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 5106 MCCLANAHAN DR SUITE B
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City | NORTH LITTLE ROCK
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State | AR
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Zip | 72116-7051
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Country | US
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Telephone | 501-539-3383
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Fax |
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Provider Business Mailing Address
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Address Line | 5106 MCCLANAHAN DR SUITE B
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City | NORTH LITTLE ROCK
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State | AR
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Zip | 72116-7051
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Country | US
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Telephone | 501-539-3383
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. BRIAN THOMAS NICHOL
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Credential | M.D.
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Telephone | 501-539-3383
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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 | E-0476
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License Number State | AR
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