NPI 1255520037

Idaho Pain Center and Anesthesia PC

Organisation Pain Medicine Physician Providence, UT

Practice location

Address: 286 N Gateway Dr, Providence, UT 84332-9733
Phone: (435) 755-9184
Fax: (435) 755-9148
Mailing address: 286 N Gateway Dr STE 201, Providence, UT 84332-5602

Authorised official

Name: Shanna Bedell
Title: Accounts Manager
Phone: (435) 755-0964

Registered specialties (2)

Pain Medicine Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208VP0000X Licence 329116-1204 (UT)

Other Pain Medicine providers in Utah →

Interventional Pain Medicine Physician

Allopathic & Osteopathic Physicians Taxonomy 208VP0014X Licence 329116-1204 (UT)

Registry record

NPI: 1255520037
Entity type: Organization
NPI issued: 17 Oct 2007
Record last updated: 18 Jul 2013

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.