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NPI Code Detail

MEDICARE: ADVANCED PAIN CLINIC, P.C.

MEDICARE: ADVANCED PAIN CLINIC, P.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialistMD12669TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1$$$$$$$$$OTHERTNSOCIAL SECURITY NUMBER

General Provider Information

NPI Number : 1104145689
Entity Type Code : Organization
Provider Name (Legal Business Name) : ADVANCED PAIN CLINIC, P.C.
Provider Business Mailing Address
First Line : PO BOX 190
Second Line :
City : FRANKLIN
State : TN
Zip : 37065-0190
Country : US
Telephone Number : 615-794-5009
Fax Number : 615-790-7531
Provider Business Practice Location Address
First Line : 1345 W MAIN ST
Second Line :
City : FRANKLIN
State : TN
Zip : 37064-3703
Country : US
Telephone Number : 615-794-5009
Fax Number : 615-790-7531
Authorized Official
Title or Position : MEDICAL DIRECTOR
Name : GIOVANNI FACCIA
Credential : M.D.
Telephone Number : 615-794-5009
Provider Enumeration Date : 05/24/2010
Last Update Date : 05/21/2020

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