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Organization
CORDOVA PAIN SPECIALISTS, PLLC
Active
Organization
CORDOVA PAIN SPECIALISTS, PLLC
Active
Other names
Cordova Pain Specialists, PLLC, NorthStar Pain Management
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN WYATT MILES DO (AUTHORIZED OFFICIAL)
(901) 444-3950
Entity
Organization
Contact information
Practice address
1540 APPLING CARE LN, SUITE 105, CORDOVA, TN 38016-4957
(901) 444-3950
(901) 444-3866
Mailing address
1540 APPLING CARE LN, SUITE 105, CORDOVA, TN 38016-4957
(901) 444-3950
(901) 444-3866
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
2168
TN
208VP0000X
Pain Medicine Physician
Primary
2168
TN
Other
Enumeration date
07/06/2014
Last updated
03/26/2018
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