Provider Demographics
NPI:1033130208
Name:JAMES R. NUNLEY D.O.,P.C.
Entity Type:Organization
Organization Name:JAMES R. NUNLEY D.O.,P.C.
Other - Org Name:INTERVENTIONAL SPINE AND PAIN CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:RANDI
Authorized Official - Middle Name:
Authorized Official - Last Name:KERSH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:931-728-5607
Mailing Address - Street 1:PO BOX 299
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:TN
Mailing Address - Zip Code:37349-0299
Mailing Address - Country:US
Mailing Address - Phone:931-728-5607
Mailing Address - Fax:931-728-8354
Practice Address - Street 1:2345 MURFREESBORO HWY
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:TN
Practice Address - Zip Code:37355-3206
Practice Address - Country:US
Practice Address - Phone:931-728-5607
Practice Address - Fax:931-728-8354
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN7268183OtherAETNA PPO GROUP #
TN3627901Medicaid
TN3301090Medicare PIN