Healthcare Provider Details

I. General information

NPI: 1598642175
Provider Name (Legal Business Name): ATLANTA PAIN AND SPINE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2025
Last Update Date: 10/02/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 INTERSTATE NORTH PKWY SE STE 1125 STE 1125
ATLANTA GA
30339
US

IV. Provider business mailing address

400 INTERSTATE NORTH PKWY SE STE 1125
ATLANTA GA
30339
US

V. Phone/Fax

Practice location:
  • Phone: 678-528-1334
  • Fax:
Mailing address:
  • Phone: 678-528-1334
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: CHRIS KITTEL
Title or Position: COO
Credential:
Phone: 678-528-1334