Provider Demographics
NPI:1710180450
Name:BARRETT PAIN ASSOCIATES, INC
Entity type:Organization
Organization Name:BARRETT PAIN ASSOCIATES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHELLEY
Authorized Official - Middle Name:J
Authorized Official - Last Name:SHANE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-473-6615
Mailing Address - Street 1:844 BOULEVARD ST
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:OH
Mailing Address - Zip Code:44622-2008
Mailing Address - Country:US
Mailing Address - Phone:330-473-6615
Mailing Address - Fax:330-365-9970
Practice Address - Street 1:844 BOULEVARD ST
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:OH
Practice Address - Zip Code:44622-2008
Practice Address - Country:US
Practice Address - Phone:330-473-6615
Practice Address - Fax:330-365-9970
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-08
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2791680Medicaid
OHBA9369231Medicare PIN