Provider Demographics
NPI:1679075527
Name:GEORGIA PAIN AND SPINE CARE, INC
Entity Type:Organization
Organization Name:GEORGIA PAIN AND SPINE CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROY
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:BROWNLOW
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-252-7557
Mailing Address - Street 1:1665 HIGHWAY 34 E STE 100
Mailing Address - Street 2:
Mailing Address - City:NEWNAN
Mailing Address - State:GA
Mailing Address - Zip Code:30265-2404
Mailing Address - Country:US
Mailing Address - Phone:770-252-7557
Mailing Address - Fax:770-252-7513
Practice Address - Street 1:105A CORPORATE PLAZA DR
Practice Address - Street 2:
Practice Address - City:LAGRANGE
Practice Address - State:GA
Practice Address - Zip Code:30241-2801
Practice Address - Country:US
Practice Address - Phone:678-800-0099
Practice Address - Fax:770-252-7513
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-07
Last Update Date:2022-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA000408208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty