Provider Demographics
NPI:1992062863
Name:COLUMBUS CENTER FOR PAIN MANAGEMENT
Entity type:Organization
Organization Name:COLUMBUS CENTER FOR PAIN MANAGEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AGENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:GEORGE
Authorized Official - Last Name:JAMES
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:419-843-1370
Mailing Address - Street 1:7071 W CENTRAL AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43617-2700
Mailing Address - Country:US
Mailing Address - Phone:419-843-1369
Mailing Address - Fax:419-843-8402
Practice Address - Street 1:85 MCNAUGHTEN RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43213-2174
Practice Address - Country:US
Practice Address - Phone:419-843-1370
Practice Address - Fax:419-843-8402
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-17
Last Update Date:2012-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Single Specialty