Provider Demographics
NPI:1447671672
Name:PAIN & REHABILITATION CONSULTANTS
Entity type:Organization
Organization Name:PAIN & REHABILITATION CONSULTANTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NORMAN
Authorized Official - Middle Name:EUGENE
Authorized Official - Last Name:MCCOOMER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:256-464-7855
Mailing Address - Street 1:44 HUGHES RD.
Mailing Address - Street 2:SUITE 2500
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758
Mailing Address - Country:US
Mailing Address - Phone:256-464-7855
Mailing Address - Fax:855-301-8314
Practice Address - Street 1:44 HUGHES RD.
Practice Address - Street 2:SUITE 2500
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758
Practice Address - Country:US
Practice Address - Phone:256-464-7855
Practice Address - Fax:855-301-8314
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-13
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2081P2900X
AL290006208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Single Specialty
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200830700Medicaid
AL000103793Medicaid