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NPI Code Detail

MEDICARE: COMPREHENSIVE PAIN MANAGEMENT LLC

MEDICARE: COMPREHENSIVE PAIN MANAGEMENT LLC
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
1261QA1903XAmbulatory Surgical Clinic/Center

General Provider Information

NPI Number : 1548418320
Entity Type Code : Organization
Provider Name (Legal Business Name) : COMPREHENSIVE PAIN MANAGEMENT LLC
Provider Business Mailing Address
First Line : 2089 SOUTH RIDGE DRIVE
Second Line :
City : TUPELO
State : MS
Zip : 38801-6478
Country : US
Telephone Number : 662-407-0801
Fax Number : 662-407-0807
Provider Business Practice Location Address
First Line : 2089 SOUTH RIDGE DR.
Second Line :
City : TUPELO
State : MS
Zip : 38801-6478
Country : US
Telephone Number : 662-407-0801
Fax Number : 662-407-0807
Authorized Official
Title or Position : PRESIDENT
Name : DR. GEORGE M HAMMITT III
Credential : MD
Telephone Number : 662-407-0801
Provider Enumeration Date : 09/04/2008
Last Update Date : 10/15/2012

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Directions to “COMPREHENSIVE PAIN MANAGEMENT LLC ” Practice Location

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