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Organization

FORD CENTER FOR PAIN MANAGEMENT

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DENNIS C. FORD MD (OWNER SUPERVISING M.D.)
(423) 614-0535
Entity
Organization

Contact information

Practice address
2020 KEITH ST NW, STE C, CLEVELAND, TN 37311-1351
(423) 614-0535
(423) 614-0545
Mailing address
2020 KEITH ST NW, STE C, CLEVELAND, TN 37311-1351
(423) 614-0535
(423) 614-0545

Taxonomy

Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
10501
TN
207Q00000X
Family Medicine Physician
12143
TN
208VP0014X
Interventional Pain Medicine Physician
Primary
1196
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3377550
MEDICARE GROUP
TN
05
3377550
TN
01
4041359
MD BLUE CROSS BLUE SHIELD
TN
01
44D1041380
DEPT HEALTH CLIA
TN
Enumeration date
03/12/2007
Last updated
04/28/2010
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