Provider Demographics
NPI:1245306232
Name:PRACTICE OF PAIN MANAGEMENT PLC
Entity type:Organization
Organization Name:PRACTICE OF PAIN MANAGEMENT PLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:BARTHOLOMEW
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:615-860-3500
Mailing Address - Street 1:170-D EAST MAIN STREET
Mailing Address - Street 2:PMB 115
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37075-2579
Mailing Address - Country:US
Mailing Address - Phone:615-860-3500
Mailing Address - Fax:615-860-2420
Practice Address - Street 1:3443 DICKERSON PIKE
Practice Address - Street 2:SUITE 590
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37207-2519
Practice Address - Country:US
Practice Address - Phone:615-860-3500
Practice Address - Fax:615-860-2420
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-28
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
=========OtherFEDERAL TAX ID NUMBER