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SOUTHEAST REGIONAL PAIN CTR PC NPI 1194833970


NPI Information

NPI: 1194833970
Provider Name: SOUTHEAST REGIONAL PAIN CTR PC
Classification: Pain Medicine - 208VP0014X
Entity Type: Organization

Specialization: Interventional Pain Medicine

CLIA Number: 11D1078160

Address:
5669 WHITESVILLE ROAD
COLUMBUS, GA
ZIP 31904
Phone: (706) 571-7246
Get Directions

SOUTHEAST REGIONAL PAIN CTR PC is an interventional pain medicine pain medicine in Columbus, 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. SOUTHEAST REGIONAL PAIN CTR PC NPI is 1194833970. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

5669 WHITESVILLE ROAD
COLUMBUS, GA
ZIP 31904
Phone: (706) 571-7246
Fax: (706) 571-8820

The provider's authorized official is Kenneth Barngrover .
The authorized official title is President and has the following contact phone number (706) 571-7246.

The CLIA number assigned to this NPI record is 11D1078160 - physician office with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 8/29/2006 and was last updated on 2/14/2017.


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 Medicine027027GEORGIAYes

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
1C71138MEDICARE UPIN
2000296777EMEDICAIDGEORGIA
305BD0CDMEDICARE ID-TYPE UNSPECIFIED
46311670001MEDICARE 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: 11/14/2023

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