MEDICARE: THE HEMLOCK PAIN CENTER, LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number State
1	207L00000X	Anesthesiology Physician	GA
2	208VP0000X	Pain Medicine Physician	GA
3	363A00000X	Physician Assistant	GA
4	207LP2900X	Pain Medicine (Anesthesiology) Physician	GA
5	208VP0014X	Interventional Pain Medicine Physician	GA

General Provider Information

NPI Number	:	1932576865
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE HEMLOCK PAIN CENTER, LLC

Provider Business Mailing Address
First Line	:	101 PRESTON CT STE 103
Second Line	:
City	:	MACON
State	:	GA
Zip	:	31210-5771
Country	:	US
Telephone Number	:	478-745-2385
Fax Number	:	478-745-1225

Provider Business Practice Location Address
First Line	:	312 MARGIE DR
Second Line	:
City	:	WARNER ROBINS
State	:	GA
Zip	:	31088-8913
Country	:	US
Telephone Number	:	478-745-2385
Fax Number	:	478-745-1225

Authorized Official
Title or Position	:	PRESIDENT
Name	:	STEPHEN NGWA TAFOR
Credential	:	MD
Telephone Number	:	478-745-2385

Provider Enumeration Date	:	08/26/2015
Last Update Date	:	06/17/2026

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Directions to “THE HEMLOCK PAIN CENTER, LLC ” Practice Location

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