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General NPI Number Information
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NPI Number | 1841435542
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Entity Type | Organization
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Legal Business Name | GUILFORD PAIN MANAGEMENT,PA
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Dates
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Enumeration Date | 12/09/2008
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Last Update Date | 03/30/2009
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Provider Practice Location Address
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Address Line | 522 N ELAM AVE STE 203
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City | GREENSBORO
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State | NC
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Zip | 27403-1151
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Country | US
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Telephone | 336-852-8444
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Fax | 336-852-8401
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Provider Business Mailing Address
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Address Line | 522 N ELAM AVE STE 203
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City | GREENSBORO
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State | NC
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Zip | 27403-1151
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Country | US
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Telephone | 336-852-8444
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Fax | 336-852-8401
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Authorized Official
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Title or Position | OWNER
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Name | MR. MARK LUCAS PHILLIPS
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Credential | MD
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Telephone | 336-852-8444
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP3300X
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Taxonomy Name | Pain Clinic/Center
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License Number |
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License Number State |
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