MEDICARE: PREMIER INJURY SPECIALIST

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
1	208VP0000X	Pain Medicine Physician

General Provider Information

NPI Number	:	1750215976
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PREMIER INJURY SPECIALIST

Provider Business Mailing Address
First Line	:	PO BOX 2811
Second Line	:
City	:	PEACHTREE CITY
State	:	GA
Zip	:	30269-0811
Country	:	US
Telephone Number	:	678-464-3078
Fax Number	:

Provider Business Practice Location Address
First Line	:	2521 PIEDMONT RD NE STE 2101
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30324-6316
Country	:	US
Telephone Number	:	678-464-3078
Fax Number	:	678-464-3078

Authorized Official
Title or Position	:	OWNER
Name	:	JOHNNY BROWN
Credential	:
Telephone Number	:	678-464-3078

Provider Enumeration Date	:	06/11/2026
Last Update Date	:	06/11/2026

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