Basic Information
| Provider Information | |||||||||
| NPI: | 1093470247 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HOSPITAL & MEDICAL FOUNDATION OF PARIS INC | ||||||||
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| OtherOrganizationName: | SYCAMORE PAIN & WELLNESS | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 721 E COURT ST | ||||||||
| Address2: | |||||||||
| City: | PARIS | ||||||||
| State: | IL | ||||||||
| PostalCode: | 619442460 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2174654141 | ||||||||
| FaxNumber: | 2174655615 | ||||||||
| Practice Location | |||||||||
| Address1: | 1378 S STATE ROAD 46 | ||||||||
| Address2: | |||||||||
| City: | TERRE HAUTE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 478039787 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8128773310 | ||||||||
| FaxNumber: | 8128773005 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/03/2021 | ||||||||
| LastUpdateDate: | 01/10/2022 | ||||||||
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| AuthorizedOfficialLastName: | ADAMS | ||||||||
| AuthorizedOfficialFirstName: | MARTIN | ||||||||
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| AuthorizedOfficialTitleorPosition: | VP OF FINANCE / CFO | ||||||||
| AuthorizedOfficialTelephone: | 2174664246 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 01/10/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WP0000X | N | 193200000X MULTI-SPECIALTY GROUP | Nursing Service Providers | Registered Nurse | Pain Management | 2081P2900X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | Pain Medicine | 2084P2900X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Pain Medicine | 208VP0000X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Pain Medicine | Pain Medicine | 208VP0014X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Pain Medicine | Interventional Pain Medicine | 207LP2900X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine |
No ID Information.