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General NPI Number Information
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NPI Number | 1043390149
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Entity Type | Organization
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Legal Business Name | PAIN SPECIALIST CORP.
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Dates
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Enumeration Date | 10/16/2006
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Last Update Date | 08/30/2010
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Provider Practice Location Address
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Address Line | 1506 ROCK QUARRY RD
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City | STOCKBRIDGE
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State | GA
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Zip | 30281-5047
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Country | US
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Telephone | 770-507-6995
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Fax | 770-507-8252
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Provider Business Mailing Address
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Address Line | 1506 ROCK QUARRY RD
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City | STOCKBRIDGE
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State | GA
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Zip | 30281-5047
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Country | US
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Telephone | 770-507-6995
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Fax | 770-507-8252
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Authorized Official
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Title or Position | PRESIDENT / OWNER
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Name | ANA MARIA PLATON
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Credential | MD
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Telephone | 770-507-6995
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number |
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License Number State | GA
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