Provider Demographics
NPI:1366992992
Name:CANE RIVER PAIN CENTER LLC
Entity type:Organization
Organization Name:CANE RIVER PAIN CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAND
Authorized Official - Middle Name:S
Authorized Official - Last Name:METOYER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:985-788-3936
Mailing Address - Street 1:PO BOX 2298
Mailing Address - Street 2:
Mailing Address - City:NATCHITOCHES
Mailing Address - State:LA
Mailing Address - Zip Code:71457-2298
Mailing Address - Country:US
Mailing Address - Phone:318-214-4401
Mailing Address - Fax:318-214-4493
Practice Address - Street 1:501 KEYSER AVE
Practice Address - Street 2:
Practice Address - City:NATCHITOCHES
Practice Address - State:LA
Practice Address - Zip Code:71457-6018
Practice Address - Country:US
Practice Address - Phone:318-214-4165
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-06
Last Update Date:2016-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty