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General NPI Number Information
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NPI Number | 1982313532
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Entity Type | Organization
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Legal Business Name | VERISPINE JOINT CENTERS PC
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Dates
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Enumeration Date | 11/22/2022
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Last Update Date | 10/31/2025
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Provider Practice Location Address
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Address Line | 1506 ROCK QUARRY RD
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City | STOCKBRIDGE
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State | GA
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Zip | 30281-5047
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Country | US
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Telephone | 678-782-7999
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Fax | 404-334-7274
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Provider Business Mailing Address
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Address Line | 1506 ROCK QUARRY RD
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City | STOCKBRIDGE
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State | GA
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Zip | 30281-5047
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Country | US
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Telephone | 678-782-7999
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Fax | 404-334-7274
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Authorized Official
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Title or Position | BILLING/CREDENTIALING COORDINATOR
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Name | TYE MCCLELLAN
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Credential |
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Telephone | 678-786-7181
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine 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 | 261QP3300X
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Taxonomy Name | Pain Clinic/Center
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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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