Provider Demographics
NPI:1164475075
Name:PAIN RELIEF SPECIALISTS, INC
Entity Type:Organization
Organization Name:PAIN RELIEF SPECIALISTS, INC
Other - Org Name:ANESTHESIA AND PAIN MANAGEMENT ASSOCIATES OF SOUTH GEORGIA, PC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER OF GROUP
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:G
Authorized Official - Last Name:SHIELDS
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:478-971-1080
Mailing Address - Street 1:200 S HOUSTON LAKE RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31088-9006
Mailing Address - Country:US
Mailing Address - Phone:478-971-1080
Mailing Address - Fax:478-971-1187
Practice Address - Street 1:200 S HOUSTON LAKE RD
Practice Address - Street 2:SUITE A
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31088-9006
Practice Address - Country:US
Practice Address - Phone:478-971-1080
Practice Address - Fax:478-971-1187
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-19
Last Update Date:2012-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA027911207L00000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA6213190001Medicare NSC