Provider Demographics
NPI:1730124413
Name:ESCORCIA,, EDUARDO (MD)
Entity Type:Individual
Prefix:
First Name:EDUARDO
Middle Name:
Last Name:ESCORCIA,
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3390 PEACHTREE NERD 1500
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30326-2822
Mailing Address - Country:US
Mailing Address - Phone:404-403-8310
Mailing Address - Fax:770-929-9092
Practice Address - Street 1:110 EVANS MILL DR STE 803
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:GA
Practice Address - Zip Code:30157-1642
Practice Address - Country:US
Practice Address - Phone:770-948-6824
Practice Address - Fax:770-948-6804
Is Sole Proprietor?:No
Enumeration Date:2006-06-18
Last Update Date:2019-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA063581207L00000X, 208VP0014X, 208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine