Provider Demographics
NPI:1568700391
Name:GENESIS ANALGESIA CENTER PLLC
Entity Type:Organization
Organization Name:GENESIS ANALGESIA CENTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORGANIZING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:NEWMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:252-414-7395
Mailing Address - Street 1:1408 CURRIER LN
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37919-8821
Mailing Address - Country:US
Mailing Address - Phone:865-692-4141
Mailing Address - Fax:
Practice Address - Street 1:1408 CURRIER LN
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37919-8821
Practice Address - Country:US
Practice Address - Phone:865-607-3851
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-29
Last Update Date:2013-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD20094207LP2900X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty