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SOUTHERN PAIN AND SPINE ASSOCIATES LLC NPI 1093469355


NPI Information

NPI: 1093469355
Provider Name: SOUTHERN PAIN AND SPINE ASSOCIATES LLC

Other Name: SOUTHERN PAIN AND SPINE - JASPER

Classification: Pain Medicine - 208VP0014X
Entity Type: Organization

Specialization: Interventional Pain Medicine

CLIA Number: 11D2204835

Address:
1101 OLD PHILADELPHIA RD STE G100
JASPER, GA
ZIP 30143
Phone: (678) 971-4167
Get Directions

SOUTHERN PAIN AND SPINE ASSOCIATES LLC is an interventional pain medicine pain medicine in Jasper, 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. SOUTHERN PAIN AND SPINE ASSOCIATES LLC NPI is 1093469355. The provider is registered as an organization entity type and is a single specialty group.
The provider Other Name Is Southern Pain And Spine - Jasper.

The provider's business location address is:

1101 OLD PHILADELPHIA RD STE G100
JASPER, GA
ZIP 30143-044
Phone: (678) 971-4167
Fax: (833) 989-2501

The provider's authorized official is Hamish Patel .
The authorized official title is Coo and has the following contact phone number (470) 628-9203.

The CLIA number assigned to this NPI record is 11D2204835 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/7/2022 and was last updated on 5/25/2022.


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
172139OTHERGEORGIAGCMB

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

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