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General NPI Number Information
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NPI Number | 1164475075
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Entity Type | Organization
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Legal Business Name | PAIN RELIEF SPECIALISTS, INC
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Dates
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Enumeration Date | 05/19/2006
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Last Update Date | 09/11/2012
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Provider Practice Location Address
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Address Line | 200 S HOUSTON LAKE RD SUITE A
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City | WARNER ROBINS
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State | GA
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Zip | 31088-9006
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Country | US
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Telephone | 478-971-1080
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Fax | 478-971-1187
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Provider Business Mailing Address
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Address Line | 200 S HOUSTON LAKE RD SUITE A
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City | WARNER ROBINS
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State | GA
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Zip | 31088-9006
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Country | US
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Telephone | 478-971-1080
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Fax | 478-971-1187
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Authorized Official
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Title or Position | OWNER OF GROUP
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Name | JAMES G SHIELDS JR.
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Credential | MD
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Telephone | 478-971-1080
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 027911
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 027911
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License Number State | GA
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