# CORDOVA PAIN SPECIALISTS, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Cordova Pain Specialists, PLLC, NorthStar Pain Management
- **Organization subpart:** No

## Provider details

- **NPI number:** 1437565900
- **Authorized official:** JOHN WYATT MILES DO (AUTHORIZED OFFICIAL)
- **Authorized official phone:** (901) 444-3950

## Contact information

- **Practice address:** 1540 APPLING CARE LN, SUITE 105, CORDOVA, TN 38016-4957
- **Practice address phone:** (901) 444-3950
- **Practice address fax:** (901) 444-3866
- **Mailing address:** 1540 APPLING CARE LN, SUITE 105, CORDOVA, TN 38016-4957
- **Mailing address phone:** (901) 444-3950
- **Mailing address fax:** (901) 444-3866

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | 2168 | TN | — |
| 208VP0000X | Pain Medicine Physician | 2168 | TN | Yes |

## Other

- **Enumeration date:** 07/06/2014
- **Last updated:** 03/26/2018