MEDICARE: SPECIALISTS IN PAIN MANAGEMENT, PLLC DBA SPINE & PAIN ASSOCIATES

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
1	335E00000X	Prosthetic/Orthotic Supplier

General Provider Information

NPI Number	:	1568867992
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPECIALISTS IN PAIN MANAGEMENT, PLLC DBA SPINE & PAIN ASSOCIATES

Provider Business Mailing Address
First Line	:	4957 SWINYAR DR STE 101
Second Line	:
City	:	OOLTEWAH
State	:	TN
Zip	:	37363-2205
Country	:	US
Telephone Number	:	423-362-7777
Fax Number	:	423-362-7778

Provider Business Practice Location Address
First Line	:	4957 SWINYAR DR STE 101
Second Line	:
City	:	OOLTEWAH
State	:	TN
Zip	:	37363-2205
Country	:	US
Telephone Number	:	423-362-7777
Fax Number	:	423-362-7778

Authorized Official
Title or Position	:	HUMAN RESOURCE COORDINATOR
Name	:	JESSE HAYES
Credential	:
Telephone Number	:	423-541-1028

Provider Enumeration Date	:	10/28/2014
Last Update Date	:	05/28/2026

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