Provider Demographics
NPI:1871781633
Name:TOTAL CARE PAIN MANAGEMENT, LLC
Entity type:Organization
Organization Name:TOTAL CARE PAIN MANAGEMENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:W
Authorized Official - Last Name:HOWARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-269-9828
Mailing Address - Street 1:101 LA RUE FRANCE
Mailing Address - Street 2:STE 500
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-3144
Mailing Address - Country:US
Mailing Address - Phone:337-269-9828
Mailing Address - Fax:
Practice Address - Street 1:101 LA RUE FRANCE
Practice Address - Street 2:STE 500
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-3144
Practice Address - Country:US
Practice Address - Phone:337-269-9828
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-05
Last Update Date:2008-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5BD05Medicare PIN