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General NPI Number Information
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NPI Number | 1902231178
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Entity Type | Organization
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Legal Business Name | INTERVENTIONAL PAIN MANAGEMENT ASSOCIATES PLLC
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Dates
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Enumeration Date | 09/06/2013
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Last Update Date | 01/30/2026
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Provider Practice Location Address
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Address Line | 17 MEDICAL PLZ
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City | MOUNTAIN HOME
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State | AR
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Zip | 72653-2918
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Country | US
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Telephone | 870-425-6235
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Fax | 870-424-3774
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Provider Business Mailing Address
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Address Line | 250 BUCHER DR
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City | MOUNTAIN HOME
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State | AR
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Zip | 72653-3400
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Country | US
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Telephone | 501-247-0358
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Fax |
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | DR. MATTHEW JAMES MCNELLEY
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Credential | M.D.
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Telephone | 501-247-0358
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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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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