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General NPI Number Information
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NPI Number | 1831404284
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Entity Type | Organization
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Legal Business Name | IMAGE GUIDED PAIN MANAGEMENT, P.C.
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Dates
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Enumeration Date | 08/10/2010
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Last Update Date | 05/20/2022
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Provider Practice Location Address
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Address Line | 2923 FRANKLIN RD SW
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City | ROANOKE
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State | VA
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Zip | 24014-1001
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Country | US
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Telephone | 540-581-0882
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 843086
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City | LOS ANGELES
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State | CA
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Zip | 90084-3086
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Country | US
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Telephone | 866-674-9985
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ROBERT F. O'BRIEN
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Credential | M.D.
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Telephone | 540-581-0882
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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