Provider Demographics
NPI:1265533897
Name:SPECTRUM PAIN CLINICS INC.
Entity type:Organization
Organization Name:SPECTRUM PAIN CLINICS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:F
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:931-840-9588
Mailing Address - Street 1:PO BOX 190
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37065-0190
Mailing Address - Country:US
Mailing Address - Phone:931-840-9588
Mailing Address - Fax:933-381-5770
Practice Address - Street 1:230 E JAMES M CAMPBELL BLVD STE 102
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:TN
Practice Address - Zip Code:38401-0504
Practice Address - Country:US
Practice Address - Phone:931-840-9588
Practice Address - Fax:931-381-5770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN207QA0505X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3372106Medicare PIN
TN6407610001Medicare NSC