PHYSICIAN PAIN CAREP.C. NPI 1023273570

NPI Information

NPI: 1023273570
Provider Name: PHYSICIAN PAIN CARE,P.C.
Classification: Clinic/Center - 261QP3300X
Entity Type: Organization

Specialization: Pain

CLIA Number: 11D1090508

Address:
240 HERITAGE WALK
SUITE 101
WOODSTOCK, GA
ZIP 30188
Phone: (770) 516-7880
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PHYSICIAN PAIN CARE,P.C. is a pain clinic center in Woodstock, GA. PHYSICIAN PAIN CARE,P.C. NPI is 1023273570. The provider is registered as an organization entity type.

The provider's business location address is:

240 HERITAGE WALK
SUITE 101
WOODSTOCK, GA
ZIP 30188-875
Phone: (770) 516-7880
Fax: (770) 516-7870

The provider's authorized official is Jeffrey William Rubin .
The authorized official title is Medical Director and has the following contact phone number (770) 516-7880.

The CLIA number assigned to this NPI record is 11D1090508 - physician office with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 7/24/2008 and was last updated on 6/25/2014.

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
1	261QP3300X	Clinic/Center	Pain	030873	GEORGIA	Yes

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
1	511G700815	MEDICARE PIN	GEORGIA

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

NPI Synchronization or Removal

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