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General NPI Number Information
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NPI Number | 1942636980
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Entity Type | Organization
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Legal Business Name | MERCY CLINIC PAIN MANAGEMENT, LLC
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Dates
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Enumeration Date | 09/23/2013
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Last Update Date | 07/15/2025
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Provider Practice Location Address
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Address Line | 851 E 5TH ST STE 208
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City | WASHINGTON
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State | MO
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Zip | 63090-3129
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Country | US
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Telephone | 636-390-8097
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 776084
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City | CHICAGO
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State | IL
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Zip | 60677-6084
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Country | US
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Telephone | 314-364-4200
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR - FINANCE
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Name | KERRY DUNGER
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Credential |
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Telephone | 314-364-3707
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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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