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General NPI Number Information
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NPI Number | 1417757204
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Entity Type | Organization
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Legal Business Name | THE NEXUS PAIN CENTER OF HOUSTON COUNTY LLC
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Dates
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Enumeration Date | 03/19/2025
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Last Update Date | 03/19/2025
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Provider Practice Location Address
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Address Line | 230 INDUSTRIAL BLVD STE B
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City | DUBLIN
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State | GA
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Zip | 31021-2904
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Country | US
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Telephone | 478-474-2947
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Fax | 478-971-4004
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Provider Business Mailing Address
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Address Line | 230 SHERATON BLVD STE A
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City | MACON
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State | GA
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Zip | 31210-1358
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Country | US
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Telephone | 478-474-2947
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Fax | 478-971-4004
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Authorized Official
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Title or Position | PARTNER
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Name | CHANDRESH VITHAL VIRADIA
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Credential | MD
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Telephone | 478-971-4001
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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 |
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