Healthcare Provider Details

I. General information

NPI: 1154016350
Provider Name (Legal Business Name): CENTER FOR PAIN MANAGEMENT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/05/2023
Last Update Date: 08/14/2024
Certification Date: 08/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7470 N ORACLE RD STE 210
TUCSON AZ
85704-4440
US

IV. Provider business mailing address

4000 MERIDIAN BLVD PATTY BOU - ASC DIVISION
FRANKLIN TN
37067
US

V. Phone/Fax

Practice location:
  • Phone: 520-317-5015
  • Fax: 520-317-5184
Mailing address:
  • Phone: 702-271-8476
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KRISTINA MUSIC
Title or Position: DIRECTOR PROVIDER ENROLLMENT
Credential:
Phone: 615-465-7377