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Organization

INTERVENTIONAL PAIN CENTER, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. BRAD PAUL WILSON DO (PRESIDENT)
(615) 972-1100
Entity
Organization

Contact information

Practice address
353 NEW SHACKLE ISLAND RD STE 148C, HENDERSONVILLE, TN 37075-2366
(615) 972-1000
(615) 537-4950
Mailing address
353 NEW SHACKLE ISLAND RD, SUITE 101-A, HENDERSONVILLE, TN 37075-2379
(615) 972-1100
(615) 537-4950

Taxonomy

Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
DO0000002339
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1531251
TN
Enumeration date
03/26/2013
Last updated
10/17/2023
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