Organization
PAIN CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL A WHITE MD (PRESIDENT)
(423) 903-6796
Entity
Organization
Contact information
Practice address
294 CHUBBY DR, SUITE 2, COLUMBUS, MS 39705-1358
(662) 327-6820
Mailing address
765 TASSO LN NE, CLEVELAND, TN 37312-4559
(423) 903-6796
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
11125
MS
Other
Enumeration date
06/18/2008
Last updated
06/18/2008
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