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NPI Code Detail

MEDICARE: NEXUS PAIN CENTER OF ALBANY LLC

MEDICARE: NEXUS PAIN CENTER OF ALBANY LLC
Medicare Provider Information

Scope of Practice

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

# Taxonomy Code Taxonomy License Number License Number State
1207L00000XAnesthesiology PhysicianGA
2207LP2900XPain Medicine (Anesthesiology) PhysicianGA
3208VP0000XPain Medicine PhysicianGA
4208VP0014XInterventional Pain Medicine PhysicianGA

General Provider Information

NPI Number : 1487098174
Entity Type Code : Organization
Provider Name (Legal Business Name) : NEXUS PAIN CENTER OF ALBANY LLC
Provider Business Mailing Address
First Line : 2810 MEREDYTH DRIVE
Second Line : SUITE 100
City : ALBANY
State : GA
Zip : 31707
Country : US
Telephone Number : 229-496-1874
Fax Number : 229-329-4460
Provider Business Practice Location Address
First Line : 2810 MEREDYTH DRIVE
Second Line : SUITE 100
City : ALBANY
State : GA
Zip : 31707
Country : US
Telephone Number : 229-496-1874
Fax Number : 229-329-4460
Authorized Official
Title or Position : OWNER
Name : JOSIAH S MATTHEWS IV
Credential : MD
Telephone Number : 229-496-1874
Provider Enumeration Date : 04/24/2013
Last Update Date : 11/07/2018

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Directions to “NEXUS PAIN CENTER OF ALBANY LLC ” Practice Location

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