Provider Demographics
NPI:1891375770
Name:PREMIER PAIN & SPINE CENTER, PLLC
Entity Type:Organization
Organization Name:PREMIER PAIN & SPINE CENTER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHMIDT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:615-988-8100
Mailing Address - Street 1:3443 DICKERSON PIKE STE 590
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37207-2520
Mailing Address - Country:US
Mailing Address - Phone:615-637-7463
Mailing Address - Fax:
Practice Address - Street 1:3443 DICKERSON PIKE STE 590
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37207-2520
Practice Address - Country:US
Practice Address - Phone:615-988-8100
Practice Address - Fax:877-296-5238
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-13
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ066517Medicaid