| Doctors Pain Center, Llc | |
|
1011 Boardman Canfield Rd Boardman OH 44512 | |
| (330) 629-2888 | |
| (330) 259-9625 |
| Full Name | Doctors Pain Center, Llc |
|---|---|
| Speciality | Anesthesiology |
| Location | 1011 Boardman Canfield Rd, Boardman, Ohio |
| Authorized Official Name and Position | Tracy Lee Neuendorf (PRESIDENT/CEO/OWNER) |
| Authorized Official Contact | 3306292888 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Doctors Pain Center, Llc 1011 Boardman Canfield Rd Boardman OH 44512-4226 Ph: (330) 629-2888 | Doctors Pain Center, Llc 1011 Boardman Canfield Rd Boardman OH 44512 Ph: (330) 629-2888 |
| NPI Number | 1386698215 |
|---|---|
| Provider Enumeration Date | 05/22/2006 |
| Last Update Date | 08/21/2018 |
| Medicare PECOS PAC ID | 8426036450 |
|---|---|
| Medicare Enrollment ID | O20070417000249 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386698215 | NPI | - | NPPES |
| 111998 | Other | PA | HIGHMARK |
| 2469154 | Medicaid | OH | |
| 2462154 | Medicaid | PA | |
| 1018803700001 | Medicaid | PA | |
| 1954815 | Other | PA | HIGHMARK BC/BS |
| 340892 | Other | OH | ANTHEM |
| Provider Name | Tracy Lee Neuendorf |
|---|---|
| Provider Type | Practitioner - Interventional Pain Management |
| Provider Identifiers | NPI Number: 1275509275 PECOS PAC ID: 3971417858 Enrollment ID: I20070417000237 |
| Provider Name | Jason Sindledecker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023406394 PECOS PAC ID: 6204156219 Enrollment ID: I20210816000953 |
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