Healthcare Provider Details

I. General information

NPI: 1033286513
Provider Name (Legal Business Name): PAIN CLINIC ASSOCIATES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2006
Last Update Date: 03/15/2024
Certification Date: 03/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 HUMPHREYS CENTER DR SUITE 200
MEMPHIS TN
38120-2366
US

IV. Provider business mailing address

PO BOX 931320 PAIN CLINIC ASSOCIATES PC
ATLANTA GA
31193-1320
US

V. Phone/Fax

Practice location:
  • Phone: 901-979-8003
  • Fax: 901-979-8406
Mailing address:
  • Phone: 901-979-8001
  • Fax: 901-979-8406

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: RAY SAUNDERS
Title or Position: PRACTICE ADMINISTRATOR
Credential:
Phone: 901-507-1595