MEDICARE: INSTITUTE OF PAIN MANAGEMENT, P.C.

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
1	207LP2900X	Pain Medicine (Anesthesiology) Physician	3429	OK

Other Identifiers

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

General Provider Information

NPI Number	:	1871772004
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INSTITUTE OF PAIN MANAGEMENT, P.C.

Provider Business Mailing Address
First Line	:	3328 N CLASSEN BLVD
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73118-3428
Country	:	US
Telephone Number	:	405-524-5200
Fax Number	:

Provider Business Practice Location Address
First Line	:	3328 N CLASSEN BLVD
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73118-3428
Country	:	US
Telephone Number	:	405-524-5200
Fax Number	:

Authorized Official
Title or Position	:	C.E.O. / PRESIDENT
Name	:	LIEM TRANG
Credential	:	D.O.
Telephone Number	:	405-524-5200

Provider Enumeration Date	:	10/24/2007
Last Update Date	:	12/13/2010

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Directions to “INSTITUTE OF PAIN MANAGEMENT, P.C. ” Practice Location

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