Provider Demographics
NPI:1609890383
Name:PAIN CONSULTANTS OF EAST TENNESSEE, PLLC
Entity Type:Organization
Organization Name:PAIN CONSULTANTS OF EAST TENNESSEE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JOE
Authorized Official - Middle Name:H
Authorized Official - Last Name:BROWDER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:865-579-0552
Mailing Address - Street 1:1128 E WEISGARBER RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37909-2674
Mailing Address - Country:US
Mailing Address - Phone:865-579-0552
Mailing Address - Fax:865-579-1154
Practice Address - Street 1:1128 E WEISGARBER RD
Practice Address - Street 2:SUITE 100
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37909-2674
Practice Address - Country:US
Practice Address - Phone:865-579-0552
Practice Address - Fax:865-579-1154
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-27
Last Update Date:2012-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD14476207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4281550002Medicare NSC
3711345Medicare ID - Type Unspecified