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PAIN AND SPINE SOLUTIONS LLC NPI 1073850988


NPI Information

NPI: 1073850988
Provider Name: PAIN AND SPINE SOLUTIONS, LLC
Classification: Specialist - 174400000X
Entity Type: Organization
Address:
3974 GLEN PARK DRIVE
LITHONIA, GA
ZIP 30038
Phone: (404) 403-4567
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PAIN AND SPINE SOLUTIONS, LLC is a specialist in Lithonia, 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. PAIN AND SPINE SOLUTIONS, LLC NPI is 1073850988. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

3974 GLEN PARK DRIVE
LITHONIA, GA
ZIP 30038
Phone: (404) 403-4567
Fax: (404) 920-8185

The provider's authorized official is Marcus Polk .
The authorized official title is Anesthesiologist and has the following contact phone number (404) 403-4567.

The enumeration date for this NPI number is 1/11/2013 and was last updated on 1/11/2013.


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
1174400000XSpecialist040758GEORGIAYes

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
1000820036SMEDICAIDGEORGIA

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: 11/14/2023

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