Provider Demographics
NPI:1881205151
Name:GEORGIA REGENRX, LLC.
Entity Type:Organization
Organization Name:GEORGIA REGENRX, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:EARL
Authorized Official - Last Name:WINDSOR
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:404-407-5662
Mailing Address - Street 1:5755 N POINT PKWY STE 72
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30022-1146
Mailing Address - Country:US
Mailing Address - Phone:404-407-5662
Mailing Address - Fax:770-667-7138
Practice Address - Street 1:5755 N POINT PKWY STE 72
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30022-1146
Practice Address - Country:US
Practice Address - Phone:404-407-5662
Practice Address - Fax:770-667-7138
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-11
Last Update Date:2020-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Multi-Specialty