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LAKESIDE PAIN CENTER P.C. NPI 1477566727


NPI Information

NPI: 1477566727
Provider Name: LAKESIDE PAIN CENTER, P.C.
Classification: Pain Medicine - 208VP0014X
Entity Type: Organization

Specialization: Interventional Pain Medicine

CLIA Number: 11D1085729

Address:
6010 LAKESIDE COMMONS DR
SUITE A
MACON, GA
ZIP 31210
Phone: (478) 475-9220
Get Directions

LAKESIDE PAIN CENTER, P.C. is an interventional pain medicine pain medicine in Macon, 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. LAKESIDE PAIN CENTER, P.C. NPI is 1477566727. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

6010 LAKESIDE COMMONS DR
SUITE A
MACON, GA
ZIP 31210-779
Phone: (478) 475-9220
Fax: (478) 475-9201

The provider's authorized official is Dwayne Lee Clay .
The authorized official title is Owner and has the following contact phone number (478) 475-9220.

The CLIA number assigned to this NPI record is 11D1085729 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/15/2006 and was last updated on 12/8/2009.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208100000XPhysical Medicine & Rehabilitation042215GEORGIANo
2208VP0000XPain MedicinePain Medicine042215GEORGIANo
3208VP0014XPain MedicineInterventional Pain Medicine042215GEORGIAYes

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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