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General NPI Number Information
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NPI Number | 1134517527
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Entity Type | Organization
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Legal Business Name | NEUROLOGICAL SPINE AND PAIN
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Dates
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Enumeration Date | 01/07/2015
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Last Update Date | 08/30/2023
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Provider Practice Location Address
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Address Line | 8880 ABERCORN ST
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City | SAVANNAH
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State | GA
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Zip | 31406-4508
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Country | US
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Telephone | 912-231-4444
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Fax | 912-231-4440
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Provider Business Mailing Address
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Address Line | 8880 ABERCORN ST
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City | SAVANNAH
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State | GA
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Zip | 31406-4508
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Country | US
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Telephone | 912-656-3023
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Fax | 912-231-4440
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Authorized Official
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Title or Position | OWNER
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Name | PRISCILLA J ROSS
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Credential | MD
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Telephone | 912-656-3023
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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 | 058635
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License Number State | GA
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