Provider Demographics
NPI:1063681245
Name:ADVANCED PAIN THERAPEUTICS
Entity type:Organization
Organization Name:ADVANCED PAIN THERAPEUTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ALLEN
Authorized Official - Middle Name:RICARDO
Authorized Official - Last Name:FOSTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:865-689-5240
Mailing Address - Street 1:2507 MINERAL SPRINGS AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37917-1549
Mailing Address - Country:US
Mailing Address - Phone:865-689-5240
Mailing Address - Fax:865-689-5375
Practice Address - Street 1:2507 MINERAL SPRINGS AVE
Practice Address - Street 2:SUITE A
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37917-1549
Practice Address - Country:US
Practice Address - Phone:865-689-5240
Practice Address - Fax:865-689-5375
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-21
Last Update Date:2008-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000031234207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty