Healthcare Provider Details

I. General information

NPI: 1124564695
Provider Name (Legal Business Name): NOBLE TRUTH HOLDINGS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2017
Last Update Date: 08/29/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 S JEFFERSON AVE STE 202
COOKEVILLE TN
38501
US

IV. Provider business mailing address

620 S JEFFERSON AVE STE 202
COOKEVILLE TN
38501
US

V. Phone/Fax

Practice location:
  • Phone: 931-526-7246
  • Fax: 931-526-7369
Mailing address:
  • Phone: 931-526-7246
  • Fax: 931-526-7369

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QP3300X
TaxonomyPain Clinic/Center
License NumberMD0000045915
License Number StateTN

VIII. Authorized Official

Name: DR. DAVID MCAFEE
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 931-526-7246