Provider Type Icon

INTERVENTIONAL SPINE AND PAIN MANAGEMENT CENTER PC NPI 1154780914


NPI Information

NPI: 1154780914
Provider Name: INTERVENTIONAL SPINE AND PAIN MANAGEMENT CENTER, PC
Classification: Pain Medicine - 208VP0014X
Entity Type: Organization

Specialization: Interventional Pain Medicine

CLIA Number: 11D2197333

Address:
2675 N DECATUR RD
SUITE 303
DECATUR, GA
ZIP 30033
Phone: (770) 929-9033
Get Directions

INTERVENTIONAL SPINE AND PAIN MANAGEMENT CENTER, PC is an interventional pain medicine pain medicine in Decatur, GA. The provider is interventional Pain Medicine is the discipline of medicine devoted to the diagnosis and treatment of pain and related disorders principally with the application of interventional techniques in managing subacute, chronic, persistent, and intractable pain, independently or in conjunction with other modalities of treatment. INTERVENTIONAL SPINE AND PAIN MANAGEMENT CENTER, PC NPI is 1154780914. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2675 N DECATUR RD
SUITE 303
DECATUR, GA
ZIP 30033-131
Phone: (770) 929-9033

The provider's authorized official is Victoria Beck .
The authorized official title is Cfo and has the following contact phone number (404) 920-4950.

The CLIA number assigned to this NPI record is 11D2197333 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/22/2016 and was last updated on 5/16/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208VP0014XPain MedicineInterventional Pain MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
17398400010MEDICARE NSCGEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.