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NPI Code Detail

MEDICARE: DR Q PAIN & SPINE CLINIC, PA

MEDICARE: DR Q PAIN & SPINE CLINIC, PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208100000XPhysical Medicine & Rehabilitation Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1487168308
Entity Type Code : Organization
Provider Name (Legal Business Name) : DR Q PAIN & SPINE CLINIC, PA
Provider Business Mailing Address
First Line : 5700 W MARKHAM ST
Second Line :
City : LITTLE ROCK
State : AR
Zip : 72205-3328
Country : US
Telephone Number : 501-227-0184
Fax Number : 501-251-1975
Provider Business Practice Location Address
First Line : 115 MCNEIL ST
Second Line :
City : BENTON
State : AR
Zip : 72015-3345
Country : US
Telephone Number : 501-227-0184
Fax Number : 501-251-1975
Authorized Official
Title or Position : ADMINISTRATOR
Name : PAULA ANN WELCH
Credential :
Telephone Number : 501-227-0184
Provider Enumeration Date : 11/30/2017
Last Update Date : 01/23/2018

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Directions to “DR Q PAIN & SPINE CLINIC, PA ” Practice Location

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