Provider Demographics
NPI:1033286513
Name:PAIN CLINIC ASSOCIATES PLLC
Entity Type:Organization
Organization Name:PAIN CLINIC ASSOCIATES PLLC
Other - Org Name:ANESTHESIA & ANALGESIA PC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:RAY
Authorized Official - Middle Name:
Authorized Official - Last Name:SAUNDERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-507-1595
Mailing Address - Street 1:PO BOX 931320 PAIN CLINIC ASSOCIATES PC
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:31193-1320
Mailing Address - Country:US
Mailing Address - Phone:901-979-8001
Mailing Address - Fax:901-979-8406
Practice Address - Street 1:55 HUMPHREYS CENTER DR
Practice Address - Street 2:SUITE 200
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38120-2366
Practice Address - Country:US
Practice Address - Phone:901-979-8003
Practice Address - Fax:901-979-8406
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PAIN CLINIC ASSOCIATES PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-11-29
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Multi-Specialty
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
4509111OtherAETNA
CL5404OtherRAILROAD MEDICARE
TN0169349OtherBLUE CROSS TN
TN3387515Medicaid
6244941OtherCIGNA
6244941OtherCIGNA