Organization
CHATTANOOGA PAIN MANAGEMENT CENTER LLC
Active
Other names
Chattanooga Pain Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTEN OCONNOR (OFFICER/AUTHORIZED OFFICIAL)
(615) 376-7315
Entity
Organization
Contact information
Practice address
1016 EXECUTIVE DR, HIXSON, TN 37343-3995
(615) 376-7550
(615) 329-6290
Mailing address
1016 EXECUTIVE DR, HIXSON, TN 37343-3995
(615) 376-7550
(615) 329-6290
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
183
TN
261QP3300X
Pain Clinic/Center
183
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3739688
—
TN
01
—
P00267077
RAILROAD MEDICARE
TN
Enumeration date
07/09/2006
Last updated
10/04/2024
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