Provider Demographics
NPI:1629302906
Name:PAIN SOLUTIONS OF GEORGIA
Entity Type:Organization
Organization Name:PAIN SOLUTIONS OF GEORGIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING
Authorized Official - Prefix:MRS
Authorized Official - First Name:LEIGH
Authorized Official - Middle Name:W
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:
Authorized Official - Credentials:CPC
Authorized Official - Phone:910-318-9999
Mailing Address - Street 1:4286 BELLS FERRY RD NW STE 201
Mailing Address - Street 2:
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30144-1302
Mailing Address - Country:US
Mailing Address - Phone:678-710-9900
Mailing Address - Fax:678-710-8588
Practice Address - Street 1:4286 BELLS FERRY RD NW STE 201
Practice Address - Street 2:
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30144-1302
Practice Address - Country:US
Practice Address - Phone:678-710-9900
Practice Address - Fax:678-710-8588
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-20
Last Update Date:2009-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Single Specialty