Provider Demographics
NPI:1194288100
Name:ART OF MEDICINE PAIN SPECIALISTS, LLC
Entity type:Organization
Organization Name:ART OF MEDICINE PAIN SPECIALISTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DEWAYNE
Authorized Official - Middle Name:
Authorized Official - Last Name:LOCKHART
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:239-424-9846
Mailing Address - Street 1:5012 GROVELAND TER
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34119-8429
Mailing Address - Country:US
Mailing Address - Phone:239-424-9846
Mailing Address - Fax:239-424-9932
Practice Address - Street 1:3555 KRAFT RD STE 120
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34105-5037
Practice Address - Country:US
Practice Address - Phone:239-424-9846
Practice Address - Fax:239-424-9932
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-08
Last Update Date:2019-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
No207LA0401XAllopathic & Osteopathic PhysiciansAnesthesiologyAddiction MedicineGroup - Multi-Specialty