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General NPI Number Information
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NPI Number | 1932065216
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Entity Type | Organization
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Legal Business Name | BRAIN, SPINE AND PAIN INSTITUTE OF GEORGIA PC
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Dates
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Enumeration Date | 12/30/2025
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Last Update Date | 12/30/2025
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Provider Practice Location Address
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Address Line | 4300 PACES FERRY RD SE STE 500
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City | ATLANTA
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State | GA
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Zip | 30339-5714
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Country | US
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Telephone | 407-730-4240
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Fax | 407-887-1025
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Provider Business Mailing Address
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Address Line | 3343 PEACHTREE RD NE
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City | ATLANTA
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State | GA
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Zip | 30326-1085
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Country | US
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Telephone | 407-730-4240
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Fax | 407-887-1025
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | GILBERT MBEO
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Credential | MD
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Telephone | 407-730-4240
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P2900X
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Taxonomy Name | Pain Medicine (Psychiatry & Neurology) Physician
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License Number |
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License Number State |
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