Organization
LIFELINC PAIN MANAGEMENT PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC CALLAN CRNA (OWNER, CEO)
(901) 844-1590
Entity
Organization
Contact information
Practice address
308 NORTHCREST DR, SPRINGFIELD, TN 37172-3963
(866) 362-6963
(866) 362-4202
Mailing address
3340 PLAYERS CLUB PKWY, SUITE 350, MEMPHIS, TN 38125-8933
(901) 844-1590
(901) 844-1592
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
TN
208VP0000X
Pain Medicine Physician
Primary
—
TN
363L00000X
Nurse Practitioner
—
TN
367500000X
Certified Registered Nurse Anesthetist
—
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q013363
—
TN
Enumeration date
02/18/2015
Last updated
04/21/2016
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