Provider Demographics
NPI:1174799191
Name:ALABAMA PAIN MANAGEMENT, LLC
Entity type:Organization
Organization Name:ALABAMA PAIN MANAGEMENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:RICARDO
Authorized Official - Last Name:MONTIEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:334-590-0925
Mailing Address - Street 1:554 MCQUEEN SMITH RD N
Mailing Address - Street 2:
Mailing Address - City:PRATTVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36066-5558
Mailing Address - Country:US
Mailing Address - Phone:334-590-0925
Mailing Address - Fax:
Practice Address - Street 1:554 MCQUEEN SMITH RD N
Practice Address - Street 2:
Practice Address - City:PRATTVILLE
Practice Address - State:AL
Practice Address - Zip Code:36066-5558
Practice Address - Country:US
Practice Address - Phone:334-590-0925
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-30
Last Update Date:2008-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL18168207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALG56838Medicare UPIN