Provider Demographics
NPI:1033305180
Name:GEORGIA PAIN PHYSICIANS PC
Entity Type:Organization
Organization Name:GEORGIA PAIN PHYSICIANS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:EARL
Authorized Official - Last Name:WINDSOR
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:770-850-8464
Mailing Address - Street 1:2550 WINDY HILL RD SE
Mailing Address - Street 2:STE 215
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30067-8665
Mailing Address - Country:US
Mailing Address - Phone:770-850-8464
Mailing Address - Fax:770-850-9727
Practice Address - Street 1:463688 SR 200
Practice Address - Street 2:STE 7
Practice Address - City:YULEE
Practice Address - State:FL
Practice Address - Zip Code:32097-0304
Practice Address - Country:US
Practice Address - Phone:904-849-1142
Practice Address - Fax:904-849-7682
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-22
Last Update Date:2014-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Single Specialty
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Single Specialty
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1279700005Medicare PIN