Provider Demographics
NPI:1699075796
Name:BLOUNT PAIN CONSULTANTS LLC
Entity type:Organization
Organization Name:BLOUNT PAIN CONSULTANTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JAMIES
Authorized Official - Middle Name:
Authorized Official - Last Name:CORDES
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:865-684-4810
Mailing Address - Street 1:186 AIRPORT PLAZA BLVD
Mailing Address - Street 2:SUITE E
Mailing Address - City:ALCOA
Mailing Address - State:TN
Mailing Address - Zip Code:37701-3182
Mailing Address - Country:US
Mailing Address - Phone:865-684-4810
Mailing Address - Fax:865-238-5142
Practice Address - Street 1:186 AIRPORT PLAZA BLVD
Practice Address - Street 2:SUITE E
Practice Address - City:ALCOA
Practice Address - State:TN
Practice Address - Zip Code:37701-3182
Practice Address - Country:US
Practice Address - Phone:865-684-4810
Practice Address - Fax:865-238-5142
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-25
Last Update Date:2010-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Single Specialty