Provider Demographics
NPI:1356574552
Name:INTEGRATIVE PAIN SOLUTIONS PLLC
Entity type:Organization
Organization Name:INTEGRATIVE PAIN SOLUTIONS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:P
Authorized Official - Last Name:RUPERT
Authorized Official - Suffix:
Authorized Official - Credentials:MD, MS, FIPP
Authorized Official - Phone:615-550-8500
Mailing Address - Street 1:100 COVEY DR
Mailing Address - Street 2:SUITE 103
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-5665
Mailing Address - Country:US
Mailing Address - Phone:615-550-8500
Mailing Address - Fax:615-550-8501
Practice Address - Street 1:100 COVEY DR
Practice Address - Street 2:SUITE 103
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-5665
Practice Address - Country:US
Practice Address - Phone:615-550-8500
Practice Address - Fax:615-550-8501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-03
Last Update Date:2010-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN6379580001Medicare NSC