Healthcare Provider Details

I. General information

NPI: 1427479328
Provider Name (Legal Business Name): TENNESSEE PAIN MANAGEMENT ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2013
Last Update Date: 04/03/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

530 US HWY 64 SUITE 5
WAYNESBORO TN
38485
US

IV. Provider business mailing address

PO BOX 655
WAYNESBORO TN
38485-0655
US

V. Phone/Fax

Practice location:
  • Phone: 931-332-4131
  • Fax: 931-722-9627
Mailing address:
  • Phone: 931-722-6690
  • Fax: 931-722-6691

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: DR. JOE I HALL
Title or Position: OWNER
Credential: M.D.
Phone: 931-722-4242