Healthcare Provider Details

I. General information

NPI: 1942291786
Provider Name (Legal Business Name): PAIN CLINIC OF AIMR
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2911 PIEDMONT RD NE STE F
ATLANTA GA
30305-2783
US

IV. Provider business mailing address

2911 PIEDMONT RD NE STE F
ATLANTA GA
30305-2783
US

V. Phone/Fax

Practice location:
  • Phone: 404-365-0160
  • Fax: 404-365-0751
Mailing address:
  • Phone: 404-365-0160
  • Fax: 404-365-0751

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number038830
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number038830
License Number StateGA

VIII. Authorized Official

Name: MR. LAWRENCE E EPPELBAUM
Title or Position: PRESIDENT
Credential: MD
Phone: 404-365-0160