Provider Demographics
NPI:1588710289
Name:THE CENTER FOR PAIN OF MONTGOMERY LLC
Entity type:Organization
Organization Name:THE CENTER FOR PAIN OF MONTGOMERY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:BRADLEY
Authorized Official - Middle Name:P
Authorized Official - Last Name:KATZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:334-288-7808
Mailing Address - Street 1:201 DEFENSE HWY STE 260
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-7096
Mailing Address - Country:US
Mailing Address - Phone:334-288-7808
Mailing Address - Fax:334-387-3090
Practice Address - Street 1:2065 E. S. BLVD.
Practice Address - Street 2:STE. 401
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36116
Practice Address - Country:US
Practice Address - Phone:334-288-7808
Practice Address - Fax:334-387-3090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty
No174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL529703000Medicaid
ALH426Medicare ID - Type UnspecifiedCENTER FOR PAIN GROUP NUM
ALH426Medicare ID - Type UnspecifiedCENTER FOR PAIN GROUP NUM
ALE32906Medicare UPIN
ALF35967Medicare UPIN
AL529703000Medicaid