# COOKVILLE PAIN CONSULTANTS OF PUTNAM COUNTY

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- **Entity:** Organization
- **Status:** Active
- **Other names:** PAIN CONSULTANTS OF PUTNAM COUNTY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1750649315
- **Authorized official:** CHARLOTTE D MARKS (BILLING MANAGER)
- **Authorized official phone:** (931) 952-4910

## Contact information

- **Practice address:** 580 S JEFFERSON AVE, COOKEVILLE, TN 38501-4010
- **Practice address phone:** (931) 526-7104
- **Practice address fax:** (931) 526-7105
- **Mailing address:** P O BOX 4129, COOKEVILLE, TN 38502
- **Mailing address phone:** (931) 526-7104
- **Mailing address fax:** (931) 526-7105

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | TN | Yes |
| 208VP0000X | Pain Medicine Physician | — | TN | — |

## Other

- **Enumeration date:** 05/01/2012
- **Last updated:** 05/22/2012