Southern Spine & Pain Institute

LBN: Southern Pain Institute, Pc
Southern Spine & Pain Institute is an health care organization with primary practice located at 3886 Princeton Lakes Way Sw Ste 240, Atlanta GA 30331-5511. The organization recently has only one registered license in Other Service Providers / Specialist, which is considered as the primary health care specialty. Southern Pain Institute, Pc can be contacted via phone (770) 632-3730, or through Clavo, Anthony Thaddeus via phone (770) 632-3730.

Contact Information

Primary practice address
3886 Princeton Lakes Way Sw Ste 240 Atlanta GA 30331-5511
Fax: (770) 632-3731
Website:
Authorized official contact:
Name: Clavo, Anthony Thaddeus Doctor of Medicine (MD)

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 045425 Georgia

Profile Details

NPI number 1639584378
LBN Legal business name Southern Pain Institute, Pc
DBA Doing business as Southern Spine & Pain Institute
Authorized official Clavo, Anthony Thaddeus Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Jun 20th, 2014
Last updated Jun 20th, 2014 - about 12 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1639584378 NPPES
Georgia Other GRP6066 MEDICARE ID
Georgia Other 208VP0014X MEDICARE ID

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