Healthcare Provider Details

I. General information

NPI: 1912281379
Provider Name (Legal Business Name): PCA PAIN CARE CENTER OF MURFREESBORO, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2011
Last Update Date: 10/06/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1608 WILLIAMS DRIVE 101B
MURFREESBORO TN
37129-0558
US

IV. Provider business mailing address

1608 WILLIAMS DRIVE 101B
MURFREESBORO TN
37129-0558
US

V. Phone/Fax

Practice location:
  • Phone: 615-739-6745
  • Fax: 615-891-3492
Mailing address:
  • Phone: 615-739-6745
  • Fax: 615-891-3492

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State

VIII. Authorized Official

Name: RAY STROUP
Title or Position: FRANCHISEE
Credential: MD
Phone: 800-909-9220