Healthcare Provider Details

I. General information

NPI: 1043353808
Provider Name (Legal Business Name): TENNESSEE PAIN CONSULTANTS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2007
Last Update Date: 09/13/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 BOWMAN ST SUITE C
MORRISTOWN TN
37813-3871
US

IV. Provider business mailing address

PO BOX 51410
KNOXVILLE TN
37950-1410
US

V. Phone/Fax

Practice location:
  • Phone: 423-587-8314
  • Fax: 423-585-0015
Mailing address:
  • Phone: 423-587-8314
  • Fax: 423-585-0015

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberDO0000000682
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number71290034
License Number StateTN
# 4
Primary TaxonomyN
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number5529
License Number StateTN
# 5
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP11594
License Number StateTN
# 6
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN12848
License Number StateTN

VIII. Authorized Official

Name: JOHN B SILCOX
Title or Position: PRESIDENT
Credential:
Phone: 423-587-8314