Provider Demographics
NPI:1770837866
Name:SPINE AND PAIN PHYSICIANS SURGERY CENTER, LLC
Entity Type:Organization
Organization Name:SPINE AND PAIN PHYSICIANS SURGERY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:G
Authorized Official - Last Name:HILGENHURST
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:615-310-5700
Mailing Address - Street 1:1177 ROCK SPRINGS RD
Mailing Address - Street 2:ST 130
Mailing Address - City:SMYRNA
Mailing Address - State:TN
Mailing Address - Zip Code:37167-8411
Mailing Address - Country:US
Mailing Address - Phone:615-459-3881
Mailing Address - Fax:
Practice Address - Street 1:1177 ROCK SPRINGS RD
Practice Address - Street 2:ST 130
Practice Address - City:SMYRNA
Practice Address - State:TN
Practice Address - Zip Code:37167-8411
Practice Address - Country:US
Practice Address - Phone:615-459-3881
Practice Address - Fax:615-459-3884
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-29
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical