Provider Demographics
NPI:1982737680
Name:THERAPEUTIC PAIN SERVICES
Entity type:Organization
Organization Name:THERAPEUTIC PAIN SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:L
Authorized Official - Last Name:LIPPERT
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:719-448-0981
Mailing Address - Street 1:PO BOX 820
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80901-0820
Mailing Address - Country:US
Mailing Address - Phone:719-448-0981
Mailing Address - Fax:719-448-0767
Practice Address - Street 1:3205 N ACADEMY BLVD
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80917-5101
Practice Address - Country:US
Practice Address - Phone:719-448-0981
Practice Address - Fax:719-448-0767
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO25034207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty