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360 MEDICAL MANAGEMENT NPI 1013161637


NPI Information

NPI: 1013161637
Provider Name: 360 MEDICAL MANAGEMENT

Doing Business As: THE PAIN MANAGEMENT CLINIC OF WOODSTOCK

Classification: Specialist - 174400000X
Entity Type: Organization
Address:
200 PARKBROOKE DR
SUITE 200
WOODSTOCK, GA
ZIP 30189
Phone: (770) 591-8360
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360 MEDICAL MANAGEMENT is a specialist in Woodstock, GA. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. 360 MEDICAL MANAGEMENT NPI is 1013161637. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As The Pain Management Clinic Of Woodstock.

The provider's business location address is:

200 PARKBROOKE DR
SUITE 200
WOODSTOCK, GA
ZIP 30189-331
Phone: (770) 591-8360
Fax: (770) 591-8364

The provider's authorized official is Myron Moorehead .
The authorized official title is Managing Member and has the following contact phone number (770) 591-8360.

The enumeration date for this NPI number is 11/10/2008 and was last updated on 5/1/2009.


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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1174400000XSpecialist058478GEORGIAYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
101BDHWHMEDICARE PINGEORGIA

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: 5/5/2024

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.