Provider Demographics
NPI:1437459047
Name:TENNESSEE PAIN MANAGEMENT AND REHABILITATION PC
Entity Type:Organization
Organization Name:TENNESSEE PAIN MANAGEMENT AND REHABILITATION PC
Other - Org Name:TENNESSEE PAIN MANAGEMENT & REHAB CENTER, PC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER, SECRETARY
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:A
Authorized Official - Last Name:KUHAR
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:931-962-9000
Mailing Address - Street 1:2008 DECHERD BLVD
Mailing Address - Street 2:
Mailing Address - City:DECHERD
Mailing Address - State:TN
Mailing Address - Zip Code:37324-3818
Mailing Address - Country:US
Mailing Address - Phone:931-962-9000
Mailing Address - Fax:931-967-1791
Practice Address - Street 1:2008 DECHERD BLVD
Practice Address - Street 2:
Practice Address - City:DECHERD
Practice Address - State:TN
Practice Address - Zip Code:37324-3818
Practice Address - Country:US
Practice Address - Phone:931-962-9000
Practice Address - Fax:931-967-1791
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-29
Last Update Date:2013-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN18258208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNB42656Medicare UPIN