Advanced Pain Management Pllc

LBN: Advanced Pain Management Pllc
Advanced Pain Management Pllc is an health care organization with primary practice located at 2275 So Eagle Rd Sute 160, Meridian ID 83642. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Pain Medicine, which is considered as the primary health care specialty. Advanced Pain Management Pllc can be contacted via phone (208) 947-2266, or through Severson, Michael Dale via phone (208) 880-9464.

Contact Information

Primary practice address
2275 So Eagle Rd Sute 160 Meridian ID 83642
Phone: (208) 947-2266
Fax: (208) 947-2267
Website:
Map and Directions
Authorized official contact:
Name: Severson, Michael Dale Doctor of Medicine (MD)
Phone: (208) 880-9464

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pain Medicine 207LP2900X

Profile Details

NPI number 1114171519
LBN Legal business name Advanced Pain Management Pllc
DBA Doing business as
Authorized official Severson, Michael Dale Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Nov 11th, 2008
Last updated Nov 23rd, 2011 - about 13 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1114171519 NPPES
Idaho MEDICAID 808339800

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