Provider Demographics
NPI:1033546999
Name:PAIN MANAGEMENT SPECIALISTS OF ATLANTA P C
Entity Type:Organization
Organization Name:PAIN MANAGEMENT SPECIALISTS OF ATLANTA P C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RANDALL
Authorized Official - Middle Name:
Authorized Official - Last Name:BERINHOUT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:7706-506-1800
Mailing Address - Street 1:165 N PARK TRL
Mailing Address - Street 2:SUITE 100
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30281-6500
Mailing Address - Country:US
Mailing Address - Phone:770-233-8570
Mailing Address - Fax:770-228-7671
Practice Address - Street 1:616A S 8TH ST
Practice Address - Street 2:SUITE A
Practice Address - City:GRIFFIN
Practice Address - State:GA
Practice Address - Zip Code:30224-4214
Practice Address - Country:US
Practice Address - Phone:770-506-6180
Practice Address - Fax:770-506-4686
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-08
Last Update Date:2013-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty