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NPI Code Detail

MEDICARE: NORTH GEORGIA PAIN SPECIALIST, LLC

MEDICARE: NORTH GEORGIA PAIN SPECIALIST, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207LP2900XPain Medicine (Anesthesiology) Physician

General Provider Information

NPI Number : 1336474311
Entity Type Code : Organization
Provider Name (Legal Business Name) : NORTH GEORGIA PAIN SPECIALIST, LLC
Provider Business Mailing Address
First Line : PO BOX 935012
Second Line :
City : ATLANTA
State : GA
Zip : 31193-5012
Country : US
Telephone Number : 800-555-2049
Fax Number :
Provider Business Practice Location Address
First Line : 100 GROSS CRESCENT CIR
Second Line :
City : FT OGLETHORPE
State : GA
Zip : 30742-3643
Country : US
Telephone Number : 706-858-2000
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : DR. STEVEN GOTTLIEB
Credential : MD
Telephone Number : 561-799-3552
Provider Enumeration Date : 10/09/2009
Last Update Date : 10/09/2009

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Directions to “NORTH GEORGIA PAIN SPECIALIST, LLC ” Practice Location

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