Organization Active NPI

TLC Pain & Palliative Medicine Practice, Inc

  • Pain Medicine Physician
  • Tucson, AZ
National Provider Identifier
1316995376
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
License
PENDING Issued in AZ
Legal business name
TLC PAIN & PALLIATIVE MEDICINE PRACTICE, INC
Practice address
1775 E Skyline Dr
Ste 101
Tucson, AZ 85718-1162
Phone
(520) 615-6200
Fax
(520) 615-6255
NPI assigned
May 4, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Scott M Bolhack, MD
Title
President
Phone
(520) 615-6200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208VP0000X PENDING AZ Primary

Addresses

Primary practice location

1775 E Skyline Dr
Ste 101
Tucson, AZ 85718-1162

Mailing address

1775 E Skyline Dr
Ste 101
Tucson, AZ 85718-1162
Phone (520) 615-6200

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1316995376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1775 E SKYLINE DR",
            "address_2": "STE 101",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857181162",
            "telephone_number": "520-615-6200",
            "fax_number": "520-615-6255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1775 E SKYLINE DR",
            "address_2": "STE 101",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857181162",
            "telephone_number": "520-615-6200",
            "fax_number": "520-615-6255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TLC PAIN & PALLIATIVE MEDICINE PRACTICE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BOLHACK",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "520-615-6200",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "AZ",
            "license": "PENDING",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.