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General NPI Number Information
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NPI Number | 1144867391
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Entity Type | Organization
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Legal Business Name | GEORGIA INSTITUTE OF MEDICINE, LLC
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Dates
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Enumeration Date | 12/06/2019
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Last Update Date | 03/03/2025
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Provider Practice Location Address
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Address Line | 3286 BUCKEYE RD # 150
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City | ATLANTA
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State | GA
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Zip | 30341-4228
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Country | US
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Telephone | 404-267-5566
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Fax | 404-267-5565
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Provider Business Mailing Address
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Address Line | 3286 BUCKEYE RD
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City | ATLANTA
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State | GA
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Zip | 30341-4228
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Country | US
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Telephone | 404-267-5566
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Fax | 404-267-5565
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | PATRICIA BRODIE
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Credential |
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Telephone | 404-267-5566
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number |
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License Number State |
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