Basic Information
Provider Information
NPI: 1013930494
EntityType: 2
ReplacementNPI:  
OrganizationName: PRECISION PAIN CARE PLLC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: DR. CHARLES GRAFFORD HILGENHURST M.D.
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 519 ENON SPRINGS RD E
Address2:  
City: SMYRNA
State: TN
PostalCode: 371674446
CountryCode: US
TelephoneNumber: 6152236200
FaxNumber: 6152236100
Practice Location
Address1: 519 ENON SPRINGS RD E
Address2:  
City: SMYRNA
State: TN
PostalCode: 37167
CountryCode: US
TelephoneNumber: 6152236200
FaxNumber: 6152236100
Other Information
ProviderEnumerationDate: 07/26/2006
LastUpdateDate: 08/28/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: HILGENHURST
AuthorizedOfficialFirstName: CHARLES
AuthorizedOfficialMiddleName: GRAFFORD
AuthorizedOfficialTitleorPosition: OWNER
AuthorizedOfficialTelephone: 6152236200
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: DR.
AuthorizedOfficialNameSuffix: IV
AuthorizedOfficialCredential: MD
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207LP2900XMD38297TNY193400000X SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine

ID Information
IDTypeStateIssuerDescription
389324305TN MEDICAID


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