Healthcare Provider Details

I. General information

NPI: 1447535810
Provider Name (Legal Business Name): PAIN RELIEF SPECIALISTS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2011
Last Update Date: 09/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 COWLES CLINC WAY SUITE C-300
GREENSBORO GA
30642-5285
US

IV. Provider business mailing address

200 S HOUSTON LAKE RD SUITE A
WARNER ROBINS GA
31088-9006
US

V. Phone/Fax

Practice location:
  • Phone: 478-971-1080
  • Fax: 478-971-1187
Mailing address:
  • Phone: 478-971-1080
  • Fax: 478-971-1187

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JAMES G SHIELDS JR.
Title or Position: PRESIDENT
Credential: M.D.
Phone: 478-971-1080