MEDICARE: GEORGIA PAIN PHYSICIANS PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	207LP2900X	Pain Medicine (Anesthesiology) Physician
2	208VP0014X	Interventional Pain Medicine Physician
3	2081P2900X	Pain Medicine (Physical Medicine & Rehabilitation) Physician
4	208VP0000X	Pain Medicine Physician

General Provider Information

NPI Number	:	1033305180
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GEORGIA PAIN PHYSICIANS PC

Provider Business Mailing Address
First Line	:	2550 WINDY HILL RD SE
Second Line	:	STE 215
City	:	MARIETTA
State	:	GA
Zip	:	30067-8665
Country	:	US
Telephone Number	:	770-850-8464
Fax Number	:	770-850-9727

Provider Business Practice Location Address
First Line	:	463688 SR 200
Second Line	:	STE 7
City	:	YULEE
State	:	FL
Zip	:	32097-0304
Country	:	US
Telephone Number	:	904-849-1142
Fax Number	:	904-849-7682

Authorized Official
Title or Position	:	CEO/OWNER
Name	:	DR. ROBERT EARL WINDSOR JR.
Credential	:	MD
Telephone Number	:	770-850-8464

Provider Enumeration Date	:	09/22/2007
Last Update Date	:	10/16/2014

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