Provider Demographics
NPI:1487075099
Name:ASSOCIATED PAIN SPECIALISTS, PC
Entity type:Organization
Organization Name:ASSOCIATED PAIN SPECIALISTS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:HARLEY
Authorized Official - Last Name:ODELL
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:865-673-5000
Mailing Address - Street 1:1326 PAPERMILL POINTE WAY
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37909-1903
Mailing Address - Country:US
Mailing Address - Phone:865-558-3476
Mailing Address - Fax:865-330-6323
Practice Address - Street 1:1342 PAPERMILL POINTE WAY
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37909-1903
Practice Address - Country:US
Practice Address - Phone:865-673-5000
Practice Address - Fax:865-330-6323
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-27
Last Update Date:2025-02-17
Deactivation Date:2023-08-17
Deactivation Code:
Reactivation Date:2023-08-28
Provider Licenses
StateLicense IDTaxonomies
TN7068360001332B00000X, 332B00000X
261QM1300X
TN4447050332900000X
TN00000206208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-SpecialtyGroup - Single Specialty
No332900000XSuppliersNon-Pharmacy Dispensing SiteGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ002178Medicaid
TNQ002176Medicaid