Organization
TRI STATE INTERVENTIONAL PAIN CLINIC PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CAROL J MCCOURT MD (SOLE PROPRIETOR)
(901) 219-6740
Entity
Organization
Contact information
Practice address
310 JUDGE SMITH DR, MARION, AR 72364-2220
(901) 603-8555
(901) 730-1229
Mailing address
3450 LAKE POINTE, MEMPHIS, TN 38125-8842
(901) 219-6740
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
—
Other
Enumeration date
09/27/2019
Last updated
09/27/2019
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