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NPI Code Detail

MEDICARE: COMMONWEALTH INTEGRITY PAIN CENTER PLLC

MEDICARE: COMMONWEALTH INTEGRITY PAIN CENTER PLLC
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
1332B00000XDurable Medical Equipment & Medical Supplies
2207LP2900XPain Medicine (Anesthesiology) Physician

General Provider Information

NPI Number : 1689119570
Entity Type Code : Organization
Provider Name (Legal Business Name) : COMMONWEALTH INTEGRITY PAIN CENTER PLLC
Provider Business Mailing Address
First Line : 3260 BLAZER PKWY STE 102
Second Line :
City : LEXINGTON
State : KY
Zip : 40509-2116
Country : US
Telephone Number : 859-317-8714
Fax Number : 859-368-7681
Provider Business Practice Location Address
First Line : 3260 BLAZER PKWY STE 102
Second Line :
City : LEXINGTON
State : KY
Zip : 40509-2116
Country : US
Telephone Number : 859-317-8714
Fax Number : 859-368-7681
Authorized Official
Title or Position : OWNER
Name : JOSEPH SMITH
Credential : M.D.
Telephone Number : 859-948-0121
Provider Enumeration Date : 12/30/2016
Last Update Date : 02/11/2021

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Directions to “COMMONWEALTH INTEGRITY PAIN CENTER PLLC ” Practice Location

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