Provider Demographics
NPI:1457011199
Name:ALIGN SPINE AND PAIN INSTITUTE, LLC
Entity Type:Organization
Organization Name:ALIGN SPINE AND PAIN INSTITUTE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:A
Authorized Official - Last Name:KUNDUKULAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-988-7246
Mailing Address - Street 1:960 HOLCOMB BRIDGE RD STE 150
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076-1963
Mailing Address - Country:US
Mailing Address - Phone:770-988-7246
Mailing Address - Fax:770-988-7247
Practice Address - Street 1:960 HOLCOMB BRIDGE RD STE 150
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-1963
Practice Address - Country:US
Practice Address - Phone:770-988-7246
Practice Address - Fax:770-988-7247
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-21
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty