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INTERVENTIONAL SPINE AND PAIN MANAGEMENT CENTER PC NPI 1790144673


NPI Information

NPI: 1790144673
Provider Name: INTERVENTIONAL SPINE AND PAIN MANAGEMENT CENTER, PC
Classification: Pain Medicine - 208VP0014X
Entity Type: Organization

Specialization: Interventional Pain Medicine

CLIA Number: 11D2208761

Address:
4799 SUGARLOAF PKWY
SUITE 1500
LAWRENCEVILLE, GA
ZIP 30044
Phone: (404) 920-4950
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INTERVENTIONAL SPINE AND PAIN MANAGEMENT CENTER, PC is an interventional pain medicine pain medicine in Lawrenceville, 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. INTERVENTIONAL SPINE AND PAIN MANAGEMENT CENTER, PC NPI is 1790144673. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

4799 SUGARLOAF PKWY
SUITE 1500
LAWRENCEVILLE, GA
ZIP 30044-836
Phone: (404) 920-4950

The provider's authorized official is Victoria Beck .
The authorized official title is Cfo and has the following contact phone number (404) 403-8310.

The CLIA number assigned to this NPI record is 11D2208761 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/19/2016 and was last updated on 2/19/2016.


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

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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