Provider Demographics
NPI:1942693478
Name:RELIEF ANESTHESIA SOLUTIONS LLC
Entity Type:Organization
Organization Name:RELIEF ANESTHESIA SOLUTIONS LLC
Other - Org Name:THE PAIN RELIEF CENTER OF GEORGIA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF MEDICAL OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:IDI
Authorized Official - Middle Name:
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:470-481-2020
Mailing Address - Street 1:101 YORKTOWN DR STE 211
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30214-1578
Mailing Address - Country:US
Mailing Address - Phone:470-481-2020
Mailing Address - Fax:
Practice Address - Street 1:101 YORKTOWN DR STE 211
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30214-1578
Practice Address - Country:US
Practice Address - Phone:470-481-2020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-09
Last Update Date:2019-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QM2500X, 261QP3300X
GA70849208VP0014X
ALMD32921207L00000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty
No261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical SpecialtyGroup - Single Specialty
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPainGroup - Single Specialty
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty