Organization
PAIN CONSULTANTS OF WEST TENNESSEE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FRANK EDWIN JORDAN M.D. (OWNER)
(731) 660-5116
Entity
Organization
Contact information
Practice address
160 W UNIVERSITY PKWY STE C, JACKSON, TN 38305-1667
(731) 660-5116
(731) 660-5119
Mailing address
160 W UNIVERSITY PKWY STE C, JACKSON, TN 38305-1667
(731) 660-5116
(731) 660-5119
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
MD14614
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1840642
CIGNA PROVIDER NUMBER
—
01
—
3039369
BCBS PROVIDER NUMBER
TN
05
—
3708392
—
TN
Enumeration date
09/21/2007
Last updated
12/03/2007
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