| Pain Management Psychology Services, Pa | |
|
160 Kimel Forest Dr. Ste. 100 Winston-salem NC 27103-6084 | |
| (336) 770-6451 | |
| (336) 714-6475 |
| Full Name | Pain Management Psychology Services, Pa |
|---|---|
| Speciality | Psychologist |
| Location | 160 Kimel Forest Dr., Winston-salem, North Carolina |
| Authorized Official Name and Position | Timothy Norris Webster (PRESIDENT) |
| Authorized Official Contact | 3367706451 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pain Management Psychology Services, Pa 160 Kimel Forest Dr. Ste. 100 Winston-salem NC 27103-6084 Ph: (336) 770-6451 | Pain Management Psychology Services, Pa 160 Kimel Forest Dr. Ste. 100 Winston-salem NC 27103-6084 Ph: (336) 770-6451 |
| NPI Number | 1255571410 |
|---|---|
| Provider Enumeration Date | 03/02/2009 |
| Last Update Date | 10/18/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255571410 | NPI | - | NPPES |
| 6006753 | Medicaid | NC | |
| 616591400 | Other | DOL/OWCP (DEPARTMENT OF LABOR OFFICE OF WORKERS COMPENSATION PROGRAMS) |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 0388 (North Carolina) | Primary |
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