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NPI Code Detail

MEDICARE: ASCEND MEDICAL GROUP, LLC

MEDICARE: ASCEND MEDICAL GROUP, LLC
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
1261QP3300XPain Clinic/Center8034TN

General Provider Information

NPI Number : 1568758241
Entity Type Code : Organization
Provider Name (Legal Business Name) : ASCEND MEDICAL GROUP, LLC
Provider Business Mailing Address
First Line : 2001 CHARLOTTE AVE
Second Line : STE 205
City : NASHVILLE
State : TN
Zip : 37203-2032
Country : US
Telephone Number : 731-441-6317
Fax Number : 731-937-4150
Provider Business Practice Location Address
First Line : 115 HIGHWAY 641 S
Second Line :
City : CAMDEN
State : TN
Zip : 38320-1639
Country : US
Telephone Number : 731-441-6317
Fax Number : 731-937-4510
Authorized Official
Title or Position : MANAGER
Name : MS. BRENDA C MONTOGMERY
Credential :
Telephone Number : 731-441-6317
Provider Enumeration Date : 06/22/2011
Last Update Date : 06/22/2011

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Directions to “ASCEND MEDICAL GROUP, LLC ” Practice Location

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