Healthcare Provider Details

I. General information

NPI: 1063870137
Provider Name (Legal Business Name): THE PAIN MANAGEMENT GROUP, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/04/2016
Last Update Date: 02/04/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28 WHITE BRIDGE RD STE 108
NASHVILLE TN
37205-1499
US

IV. Provider business mailing address

28 WHITE BRIDGE RD STE 108
NASHVILLE TN
37205-1499
US

V. Phone/Fax

Practice location:
  • Phone: 615-941-8501
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DON JINKS
Title or Position: BILLING MANAGER
Credential:
Phone: 615-941-8501