Healthcare Provider Details

I. General information

NPI: 1689316309
Provider Name (Legal Business Name): APEX SPINE AND PAIN PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2022
Last Update Date: 04/12/2022
Certification Date: 04/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 25TH AVE N STE 203
NASHVILLE TN
37203-1593
US

IV. Provider business mailing address

310 25TH AVE N STE 203
NASHVILLE TN
37203-1593
US

V. Phone/Fax

Practice location:
  • Phone: 615-815-1560
  • Fax: 615-610-1199
Mailing address:
  • Phone: 615-815-1560
  • Fax: 615-610-1199

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: PHILLIP L. BEAULIEU
Title or Position: OWNER/DIRECTOR/MD
Credential: MD
Phone: 615-815-1560