Basic Information
| Provider Information | |||||||||
| NPI: | 1619285087 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ADVANCED PAIN TREATMENTS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 110 N MUIRFIELD CIR | ||||||||
| Address2: | |||||||||
| City: | LEBANON | ||||||||
| State: | IN | ||||||||
| PostalCode: | 460528182 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3176415183 | ||||||||
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| Practice Location | |||||||||
| Address1: | 301 E CARMEL DR | ||||||||
| Address2: | SUITE D-100 | ||||||||
| City: | CARMEL | ||||||||
| State: | IN | ||||||||
| PostalCode: | 460322888 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3176415183 | ||||||||
| FaxNumber: | 7654506161 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/20/2010 | ||||||||
| LastUpdateDate: | 09/20/2010 | ||||||||
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| AuthorizedOfficialLastName: | SRINIVASAN | ||||||||
| AuthorizedOfficialFirstName: | PATTANAM | ||||||||
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| AuthorizedOfficialTitleorPosition: | CLINICAL DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 7658910721 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208VP0014X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Pain Medicine | Interventional Pain Medicine |
No ID Information.